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NPI Code Detail

MEDICARE: DR. KASSANDRA NICOLE EVERETT D.C.

MEDICARE: DR. KASSANDRA NICOLE EVERETT D.C.
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
1111N00000XChiropractor2010014270MO

General Provider Information

NPI Number : 1316257868
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KASSANDRA NICOLE EVERETT D.C.
Provider Business Mailing Address
First Line : 1201 N DOUGLASS ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-1351
Country : US
Telephone Number : 573-276-3892
Fax Number : 573-276-3893
Provider Business Practice Location Address
First Line : 1201 N DOUGLASS ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-1351
Country : US
Telephone Number : 573-276-3892
Fax Number : 573-276-3893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2010
Last Update Date : 09/26/2022

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