Healthcare Provider Details

I. General information

NPI: 1992366546
Provider Name (Legal Business Name): CASSANDRA LEIGH BROWN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MEDICAL DR STE A
LIMA OH
45804-4030
US

IV. Provider business mailing address

801 MEDICAL DR STE A
LIMA OH
45804-4030
US

V. Phone/Fax

Practice location:
  • Phone: 419-222-6622
  • Fax: 419-224-0015
Mailing address:
  • Phone: 419-222-6622
  • Fax: 419-224-0015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF06192562
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: