Provider Demographics
NPI:1245556075
Name:MINTER, CASSAUNDRA WRIGHT (NP)
Entity type:Individual
Prefix:
First Name:CASSAUNDRA
Middle Name:WRIGHT
Last Name:MINTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CASSAUNDRA
Other - Middle Name:ANNE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL STREET
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0510
Practice Address - Country:US
Practice Address - Phone:804-828-7642
Practice Address - Fax:804-828-8321
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168747363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily