Individual
MRS. CASSANDRA LYNN STULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
MARY S SHOOK STUDENT HEALTH SERVICES, 614 HOWARD ST PO OFFICE BOX 32070, BOONE, NC 28608-2070
(828) 262-3100
(828) 262-6262
Mailing address
MARY S SHOOK STUDENT HEALTH SERVICES, 614 HOWARD ST PO OFFICE BOX 32070, BOONE, NC 28608-2070
(828) 262-3100
(828) 262-6262
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001000297
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0871437
CIGNA
NC
01
—
200205133
UNITED HEALTHCARE
NC
01
—
34D1018993
CLIA WAVE
NC
01
—
56142
HEALTHCARE SYSTEMS
NC
05
—
8989937
—
NC
01
—
89937
PROVIDER BCBS
NC
01
—
D0263
MEDCOST PROVIDER
NC
Enumeration date
05/12/2006
Last updated
07/03/2023
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