MEDICARE: CASSANDRA MUFF F. N. P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	AP118253	TX
2	363L00000X	Nurse Practitioner	45221	KS
3	363L00000X	Nurse Practitioner	775004	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063517688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA MUFF F. N. P.

Provider Business Mailing Address
First Line	:	601 S MAIN ST
Second Line	:	SUITE 200
City	:	KELLER
State	:	TX
Zip	:	76248-7029
Country	:	US
Telephone Number	:	817-753-6888
Fax Number	:	817-753-6885

Provider Business Practice Location Address
First Line	:	601 S MAIN ST
Second Line	:	SUITE 200
City	:	KELLER
State	:	TX
Zip	:	76248-7029
Country	:	US
Telephone Number	:	817-753-6888
Fax Number	:	817-753-6885

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	09/08/2023

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Directions to “ CASSANDRA MUFF F. N. P.” Practice Location

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