Provider Demographics
NPI:1801579156
Name:CASSETTE, ZERZHINSKI M (RN)
Entity type:Individual
Prefix:
First Name:ZERZHINSKI
Middle Name:M
Last Name:CASSETTE
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 1:221 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-2747
Mailing Address - Country:US
Mailing Address - Phone:217-383-4647
Mailing Address - Fax:
Practice Address - Street 1:221 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-2747
Practice Address - Country:US
Practice Address - Phone:217-383-4647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.426948163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development