Provider Demographics
NPI:1780047548
Name:SAYRE, CASSANDRA RAE (WHNP-BC)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:RAE
Last Name:SAYRE
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:WV
Mailing Address - Zip Code:25276-1826
Mailing Address - Country:US
Mailing Address - Phone:304-927-1495
Mailing Address - Fax:
Practice Address - Street 1:146 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:WV
Practice Address - Zip Code:25276-1826
Practice Address - Country:US
Practice Address - Phone:304-927-1495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN80983WHNPBC363LW0102X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SAY104397686OtherNCC
WVSAY104397686OtherNCC CERTIFICATION