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General NPI Number Information
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NPI Number | 1437035516
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Entity Type | Individual
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Provider Name | CASSIE L MISCEVIC APRN, CNP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 1505 EASTLAND DR STE 1000
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City | BLOOMINGTON
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State | IL
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Zip | 61701-7905
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Country | US
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Telephone | 309-661-6270
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Fax |
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Provider Business Mailing Address
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Address Line | 427 N WOODLAND AVE
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City | OGLESBY
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State | IL
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Zip | 61348-1175
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Country | US
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Telephone | 815-252-9900
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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 | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 209.032958
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209032958
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License Number State | IL
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