Individual
MRS. KASSANDRA PEARL CRISWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
225 MEDICAL CENTER DR STE 203, PADUCAH, KY 42003-7907
(270) 415-6100
Mailing address
1530 LONE OAK RD, PADUCAH, KY 42003
(270) 415-6100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3015708
KY
363LP2300X
Primary Care Nurse Practitioner
3015708
KY
Other
Enumeration date
01/21/2021
Last updated
10/29/2024
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