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NPI Code Detail

MEDICARE: CASSANDRA STULL

MEDICARE: CASSANDRA STULL
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1912309782
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA STULL
Provider Business Mailing Address
First Line : 520 E AUGUSTA AVE
Second Line :
City : AUGUSTA
State : KS
Zip : 67010-2100
Country : US
Telephone Number : 316-775-5491
Fax Number : 316-775-5442
Provider Business Practice Location Address
First Line : 450 N 159TH ST E
Second Line :
City : WICHITA
State : KS
Zip : 67230-7704
Country : US
Telephone Number : 316-440-1312
Fax Number : 316-440-1318
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2014
Last Update Date : 09/23/2014

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1841692639 — ELIZABETH CASANOVA
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Directions to “ CASSANDRA STULL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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