MEDICARE: CASSANDRA L ELEFTHERI AGACNP-BC

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	363LG0600X	Gerontology Nurse Practitioner	28245333A	IN

General Provider Information

NPI Number	:	1326977174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA L ELEFTHERI AGACNP-BC

Provider Business Mailing Address
First Line	:	8558 BROADWAY
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-7032
Country	:	US
Telephone Number	:	219-392-7084
Fax Number	:	219-703-6854

Provider Business Practice Location Address
First Line	:	3800 SAINT MARY RD STE 202
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-3986
Country	:	US
Telephone Number	:	219-286-3788
Fax Number	:	219-286-3791

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

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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