# MS. KASSANDRA ALYSABETH MELLOTT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1528505070
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2237 | NE | — |
| 363A00000X | Physician Assistant | 085452 | IA | — |
| 363A00000X | Physician Assistant | 2237 | NE | Yes |

## Other

- **Enumeration date:** 01/23/2017
- **Last updated:** 05/04/2022