Provider Demographics
NPI:1760845267
Name:MILTON, CASSANDRA FAYE (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:FAYE
Last Name:MILTON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MISS
Other - First Name:CASSANDRA
Other - Middle Name:FAYE
Other - Last Name:CLAYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:2971 GENA DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-5706
Mailing Address - Country:US
Mailing Address - Phone:404-402-0551
Mailing Address - Fax:
Practice Address - Street 1:2971 GENA DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-5706
Practice Address - Country:US
Practice Address - Phone:404-402-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA158697163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult