Individual
ALI CASSANDRA ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
6326 CONSTITUTION DR, FORT WAYNE, IN 46804-1518
(650) 924-1174
Mailing address
5850 KILLDEER LN APT 203, FORT WAYNE, IN 46804-0041
(574) 528-0547
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012038A
IN
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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