NPI | 1225570286 |
---|---|
Former Name | CASSANDRA L REAKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015116) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 277001899) |
363L00000X Nurse Practitioner (Licence: CO APN.0998651-NP) | |
363L00000X Nurse Practitioner (Licence: OR 202207763NP-PP) | |
Enumeration Date | 2016-11-08 |
Last Update Date | 2025-09-14 |