Provider Demographics
NPI:1063517688
Name:MUFF, CASSANDRA (F N P)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:MUFF
Suffix:
Gender:F
Credentials:F N P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-7029
Mailing Address - Country:US
Mailing Address - Phone:817-753-6888
Mailing Address - Fax:817-753-6885
Practice Address - Street 1:601 S MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-7029
Practice Address - Country:US
Practice Address - Phone:817-753-6888
Practice Address - Fax:817-753-6885
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP118253363L00000X
KS45221363L00000X
TX775004363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100403070BMedicaid
P39553Medicare UPIN
KS100403070BMedicaid
KS161323Medicare ID - Type Unspecified