Provider Demographics
NPI:1700158607
Name:O'CONNOR, CASSANDRA (RN)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N26W22451 RIDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-8865
Mailing Address - Country:US
Mailing Address - Phone:414-520-9978
Mailing Address - Fax:
Practice Address - Street 1:N26W22451 RIDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-8865
Practice Address - Country:US
Practice Address - Phone:414-520-9978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI176758-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health