Provider Demographics
NPI:1851856603
Name:COLSON, CASSIE DEANICE (APRN,FNP-C)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:DEANICE
Last Name:COLSON
Suffix:
Gender:F
Credentials:APRN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1112
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:79095-1112
Mailing Address - Country:US
Mailing Address - Phone:806-447-5311
Mailing Address - Fax:806-447-3090
Practice Address - Street 1:1011 15TH ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:TX
Practice Address - Zip Code:79095-3703
Practice Address - Country:US
Practice Address - Phone:806-447-5311
Practice Address - Fax:806-447-3090
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily