Provider Demographics
NPI:1649607656
Name:PARRA-FERRO, CASSANDRA NICOLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:NICOLE
Last Name:PARRA-FERRO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WELLNESS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2871
Mailing Address - Country:US
Mailing Address - Phone:803-749-1111
Mailing Address - Fax:803-749-0050
Practice Address - Street 1:1 WELLNESS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2871
Practice Address - Country:US
Practice Address - Phone:803-749-1111
Practice Address - Fax:803-749-0050
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCMPA2004 PAOtherSC MEDICAL LICENSE
SCMPA2004 PAOtherSC MEDICAL LICENSE