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General NPI Number Information
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NPI Number | 1053823682
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Entity Type | Individual
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Provider Name | CASSANDRA R FAGER RN
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Gender | Female
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Dates
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Enumeration Date | 11/05/2017
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 8800 BLUE RIDGE BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64138-4000
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Country | US
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Telephone | 816-966-0903
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Fax |
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Provider Business Mailing Address
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Address Line | 130 E WALDO AVE
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City | INDEPENDENCE
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State | MO
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Zip | 64050-2987
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 2016722061
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License Number State | MO
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