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General NPI Number Information
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NPI Number | 1922570373
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Entity Type | Individual
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Provider Name | CASSANDRA LYNN PREWITT FNP
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Gender | Female
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Dates
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Enumeration Date | 12/26/2018
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Last Update Date | 12/26/2018
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Provider Practice Location Address
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Address Line | 400 E 5TH AVE # 1
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City | SPOKANE
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State | WA
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Zip | 99202-1334
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Country | US
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Telephone | 509-342-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 3151 HAWTHORN ST
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City | SAN DIEGO
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State | CA
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Zip | 92104-5637
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Country | US
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Telephone | 509-220-4208
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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 | 60909563
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License Number State | WA
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