Provider Demographics
NPI:1801590823
Name:PHELIA, CASSANDRA DENISE
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:DENISE
Last Name:PHELIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 BILAMY CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1385
Mailing Address - Country:US
Mailing Address - Phone:513-609-5154
Mailing Address - Fax:
Practice Address - Street 1:911 BILAMY CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1385
Practice Address - Country:US
Practice Address - Phone:613-609-5154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRG586023343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)