Provider Demographics
NPI:1831474501
Name:CARRELL, CASSANDRA ELAINE (CRNP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ELAINE
Last Name:CARRELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 DUNN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9480
Mailing Address - Country:US
Mailing Address - Phone:256-390-3686
Mailing Address - Fax:
Practice Address - Street 1:2201 DUNN ST STE 2
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9480
Practice Address - Country:US
Practice Address - Phone:907-796-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK193053363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care