Provider Demographics
NPI:1790416808
Name:LOHREY, CASSIE JO (CNM)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:JO
Last Name:LOHREY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 DOWNY DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-1528
Mailing Address - Country:US
Mailing Address - Phone:810-577-6498
Mailing Address - Fax:
Practice Address - Street 1:2221 S 17TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7542
Practice Address - Country:US
Practice Address - Phone:810-577-6498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC367A00000X
NC839367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife