Provider Demographics
NPI:1073332383
Name:LACASSE, CHERYL (PHD, RN, AOCNS)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:LACASSE
Suffix:
Gender:F
Credentials:PHD, RN, AOCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COLLEGE OF NURSING
Mailing Address - Street 2:1305 N. MARTIN ST.
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721
Mailing Address - Country:US
Mailing Address - Phone:520-626-6321
Mailing Address - Fax:
Practice Address - Street 1:COLLEGE OF NURSING
Practice Address - Street 2:1305 N. MARTIN ST.
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721
Practice Address - Country:US
Practice Address - Phone:520-626-6321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN089910163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse