Doctor Name: | CASSI MACRAE DESKINS |
NPI Number: | 1225388671 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNPC |
License Number: | 2006006025 |
Business Practice Address: | 1600 E Evergreen Cameron, MO - 64429 |
Business Phone Number: | 8166322101 |
Business Fax Number: | 8166493383 |
Mailing Address: | 1600 E Evergreen, CAMERON |
State: | MO |
Postal Code: | 64429 |
Phone Number: | 8166322101 |
Fax Number: | 8166493383 |
NPI Enumeration Date: | 09/13/2012 |
NPI Last Update Date: | 09/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2006006025 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |