Healthcare Provider Details

I. General information

NPI: 1073213609
Provider Name (Legal Business Name): CASSANDRIA CLAUDINE STEPHENSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASSANDRIA CLAUDINE MCLEOD MCLEOD

II. Dates (important events)

Enumeration Date: 03/02/2023
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1748 W HORIZON RIDGE PKWY
HENDERSON NV
89012-4833
US

IV. Provider business mailing address

959 VIA GANDALFI
HENDERSON NV
89011-0934
US

V. Phone/Fax

Practice location:
  • Phone: 702-982-1300
  • Fax:
Mailing address:
  • Phone: 754-246-3364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number812755
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: