Provider Demographics
NPI:1952683195
Name:WINGFIELD, CASSANDRA ARLETTE (LPN)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:ARLETTE
Last Name:WINGFIELD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23407 FELCH ST
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5219
Mailing Address - Country:US
Mailing Address - Phone:216-386-0339
Mailing Address - Fax:
Practice Address - Street 1:23407 FELCH ST
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5219
Practice Address - Country:US
Practice Address - Phone:216-386-0339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 049081164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse