Healthcare Provider Details

I. General information

NPI: 1972485167
Provider Name (Legal Business Name): CASSANDRA BYRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US

IV. Provider business mailing address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US

V. Phone/Fax

Practice location:
  • Phone: 757-876-9350
  • Fax:
Mailing address:
  • Phone: 301-896-6066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number169054
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNP500226284
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: