Provider Demographics
NPI:1821577057
Name:HUNTER, KASSANDRA RAESINE (RN)
Entity Type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:RAESINE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 ROYAL FIELD LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-4585
Mailing Address - Country:US
Mailing Address - Phone:216-799-8827
Mailing Address - Fax:
Practice Address - Street 1:2630 ROYAL FIELD LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-4585
Practice Address - Country:US
Practice Address - Phone:216-799-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX848103163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics