Doctor Name: | MS. KASANDRA DINO |
NPI Number: | 1003272964 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 2015042830 |
Business Practice Address: | 1432 Riverwood Dr Pacific, MO - 630693822 |
Business Phone Number: | 3146102328 |
Business Fax Number: | |
Mailing Address: | 1432 Riverwood Dr, PACIFIC |
State: | MO |
Postal Code: | 630693822 |
Phone Number: | 3146102328 |
Fax Number: | |
NPI Enumeration Date: | 01/07/2016 |
NPI Last Update Date: | 01/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2015042830 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |