Provider Demographics
NPI:1972812931
Name:BYERS, CASSANDRA LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNN
Last Name:BYERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:LYNN
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10082 OVERLY RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43019-9349
Mailing Address - Country:US
Mailing Address - Phone:740-297-5803
Mailing Address - Fax:
Practice Address - Street 1:10082 OVERLY RD
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:OH
Practice Address - Zip Code:43019-9349
Practice Address - Country:US
Practice Address - Phone:740-297-5803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2016-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH120621164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse