Healthcare Provider Details

I. General information

NPI: 1588178776
Provider Name (Legal Business Name): CASSANDRA NOEL DENAYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 RODMAN LANE
PLYMOUTH MA
02360
US

IV. Provider business mailing address

7 RODMAN LN
PLYMOUTH MA
02360-4510
US

V. Phone/Fax

Practice location:
  • Phone: 781-588-0599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN2291861
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: