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General NPI Number Information
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NPI Number | 1154844256
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Entity Type | Individual
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Provider Name | CASSANDRA SHELTON CSA
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Gender | Female
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 07/20/2017
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Provider Practice Location Address
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Address Line | 100 KINGSLEY LANE
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City | NORFOLK
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State | VA
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Zip | 23505
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Country | US
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Telephone | 757-889-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1356 RINGGOLD ROAD
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City | RINGGOLD
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State | VA
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Zip | 24586
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Country | US
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Telephone | 434-709-5579
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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