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General NPI Number Information
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NPI Number | 1508598194
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Entity Type | Individual
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Provider Name | CASSANDRA SUE CLENDENEN MSN, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 101 KEITH ST SW
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City | CLEVELAND
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State | TN
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Zip | 37311-5804
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Country | US
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Telephone | 423-778-9671
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Fax |
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Provider Business Mailing Address
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Address Line | 7477 COMMONS BLVD APT 632
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2353
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Country | US
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Telephone | 423-255-6879
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 31969
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License Number State | TN
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