Provider Demographics
NPI:1952582256
Name:CASSANDRA DINGUS, FNP, PC
Entity Type:Organization
Organization Name:CASSANDRA DINGUS, FNP, PC
Other - Org Name:ACROSS THE TRACKS HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DINGUS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, FNP
Authorized Official - Phone:276-524-4920
Mailing Address - Street 1:205 E 19TH ST N
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-3468
Mailing Address - Country:US
Mailing Address - Phone:276-524-4920
Mailing Address - Fax:276-524-1401
Practice Address - Street 1:205 E 19TH ST N
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-3468
Practice Address - Country:US
Practice Address - Phone:276-524-4920
Practice Address - Fax:276-524-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045541261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE48450Medicare UPIN