Provider Demographics
NPI:1831861483
Name:MURRAY, CASSANDRA M
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNA
Mailing Address - Street 1:165 PEYTON RD SW STE A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-2129
Mailing Address - Country:US
Mailing Address - Phone:706-715-1660
Mailing Address - Fax:
Practice Address - Street 1:650 PONCE DE LEON AVE NE STE 300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1864
Practice Address - Country:US
Practice Address - Phone:706-406-3028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0000052382376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide