Healthcare Provider Details

I. General information

NPI: 1760857163
Provider Name (Legal Business Name): CASSANDRA FIELDS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSANDRA SUE WRIGHT

II. Dates (important events)

Enumeration Date: 12/10/2015
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N EAGLE CREEK DR SUITE 320
LEXINGTON KY
40509-1889
US

IV. Provider business mailing address

151 N EAGLE CREEK DR SUITE 320
LEXINGTON KY
40509-1889
US

V. Phone/Fax

Practice location:
  • Phone: 859-523-2526
  • Fax: 859-523-2532
Mailing address:
  • Phone: 859-523-2526
  • Fax: 859-523-2532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3009934
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number3009934
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: