Individual
CASANDRA ELAINE ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16 PEBBLE HILL DR, BELLEVILLE, IL 62223-2250
(618) 401-9304
(586) 204-0381
Mailing address
P.O. BOX 23917, 5731 MOUNT PLEASANT LN, BELLEVILLE, IL 62223-0917
(618) 401-9304
(586) 204-0381
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2015009441
MO
363LF0000X
Family Nurse Practitioner
Primary
209012471
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720474687
—
MO
Enumeration date
04/07/2015
Last updated
07/08/2021
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