Provider Demographics
NPI:1205510864
Name:FLUCK, CASSANDRA JOANN (LAY MIDWIFE)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JOANN
Last Name:FLUCK
Suffix:
Gender:F
Credentials:LAY MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 SUN VALLEY RUN
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18092-2042
Mailing Address - Country:US
Mailing Address - Phone:570-290-2626
Mailing Address - Fax:
Practice Address - Street 1:5750 SUN VALLEY RUN
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18092-2042
Practice Address - Country:US
Practice Address - Phone:570-290-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay