Provider Demographics
NPI:1750762407
Name:MEFFERT, CASSANDRA C (PA)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:C
Last Name:MEFFERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:C
Other - Last Name:TERPSTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-0001
Practice Address - Country:US
Practice Address - Phone:608-263-5442
Practice Address - Fax:608-265-1753
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3535363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical