Provider Demographics
NPI:1932301132
Name:KASSIN, CATHIE ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:CATHIE
Middle Name:ANN
Last Name:KASSIN
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 1:10731 W KELSO DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-4651
Mailing Address - Country:US
Mailing Address - Phone:623-444-9487
Mailing Address - Fax:
Practice Address - Street 1:5480 W CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-1115
Practice Address - Country:US
Practice Address - Phone:623-691-5115
Practice Address - Fax:623-691-5120
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN097220163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool