Individual
JENNIFER RAYE CASSATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1236 E RUSHOLME ST STE 150, DAVENPORT, IA 52803-2433
(563) 421-3990
(563) 421-3999
Mailing address
1236 E RUSHOLME ST STE 150, DAVENPORT, IA 52803-2433
(563) 421-3990
(563) 421-3999
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.006961
IL
363A00000X
Physician Assistant
Primary
095841
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255890869
—
IL
Enumeration date
03/14/2019
Last updated
08/10/2021
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