Individual
MRS. CASSANDRA J DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 W CHOUTEAU AVE, SUBLETTE, KS 67877-6738
(620) 510-5004
(620) 510-5007
Mailing address
PO BOX 357, SUBLETTE, KS 67877-0357
(620) 510-5004
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-77576
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
KANSAS
—
KS
Enumeration date
02/27/2017
Last updated
11/02/2023
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