Doctor Name: | VICKI NICKOLE CASSESEKA |
NPI Number: | 1083990972 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 107 H. Street East Poplar, MT - 592550067 |
Business Phone Number: | 4067682172 |
Business Fax Number: | 4067683435 |
Mailing Address: | 107 H. Street, POPLAR |
State: | MT |
Postal Code: | 592550067 |
Phone Number: | 4067682172 |
Fax Number: | 4067683435 |
NPI Enumeration Date: | 10/24/2011 |
NPI Last Update Date: | 10/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246QM0706X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Spec/Tech, Pathology |
Taxonomy Specialization: | Medical Technologist |
Taxonomy Definition: |