Individual
MS. CASSANDRA ANN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2000
Mailing address
PO BOX 632572, CINCINNATI, OH 45263-2572
(859) 341-2666
(859) 341-7867
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3014583
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050514
GROUP MEDICARE #
PA
01
—
1007307260035
MEDICAID GROUP #
PA
05
—
101291255
—
PA
01
—
120420418
DEPT OF LABOR
PA
01
—
25-1716306
INTERGROUP
PA
01
—
253420
UNISON
PA
01
—
50073153
CAPITAL BLUECROSS
PA
01
—
G9200081 85XWCU
CAREFIRST
PA
01
—
P00458420
RAILROAD MEDICARE
PA
01
—
PEARL PROVIDER
HEALTH AMERICA
PA
01
—
RN283908L
LICENSE
PA
Enumeration date
08/30/2005
Last updated
06/06/2025
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