Healthcare Provider Details

I. General information

NPI: 1881880490
Provider Name (Legal Business Name): CASSIE ANN GARNER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSIE A BURESH

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S 48TH ST SUITE 200
LINCOLN NE
68506-1276
US

IV. Provider business mailing address

10030 GREEN LEVEL CHURCH RD STE 808
CARY NC
27519-8195
US

V. Phone/Fax

Practice location:
  • Phone: 402-488-5600
  • Fax: 402-488-7649
Mailing address:
  • Phone: 919-303-4275
  • Fax: 919-303-4276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number259
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number13891
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number13891
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number113
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: