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NPI 1386026573

NPI 1386026573 : KRISTA M CASSEL CPNP-PC, IBCLC : COLUMBUS, GA

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General NPI Number Information
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    NPI Number           |    1386026573
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTA M CASSEL CPNP-PC, IBCLC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/24/2015
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    Last Update Date     |    04/09/2025
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Provider Practice Location Address
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    Address Line         |    500 BROOKSTONE CENTRE PARKWAY #100
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    City                 |    COLUMBUS
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    State                |    GA
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    Zip                  |    31904
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    Country              |    US
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    Telephone            |    706-221-4602
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    Fax                  |    706-221-4620
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Provider Business Mailing Address
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    Address Line         |    500 BROOKSTONE CENTRE PARKWAY #100
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    City                 |    COLUMBUS
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    State                |    GA
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    Zip                  |    31904
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    Country              |    US
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    Telephone            |    706-221-4602
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    Fax                  |    706-221-4620
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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        |    163WL0100X
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    Taxonomy Name        |    Lactation Consultant (Registered Nurse)
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    License Number       |    RN247812
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    License Number State |    GA
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Taxonomy #2
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    Taxonomy Code        |    363LP0200X
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    Taxonomy Name        |    Pediatric Nurse Practitioner
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    License Number       |    RN247812
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    License Number State |    GA
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