Individual
CASSIDY H PRENTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
903 N ARENDELL AVE, ZEBULON, NC 27597-2307
(919) 404-0445
(919) 404-1642
Mailing address
PO BOX 7867, ROCKY MOUNT, NC 27804-0867
(252) 451-2700
(252) 451-2702
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04382
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689009169
—
NC
Enumeration date
09/04/2013
Last updated
04/25/2014
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