Provider Demographics
NPI:1124620463
Name:COTTEN, CASSANDRA CHRISTINE
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:CHRISTINE
Last Name:COTTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 LAS VEGAS BLVD N APT 2061
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-5894
Mailing Address - Country:US
Mailing Address - Phone:702-561-2465
Mailing Address - Fax:
Practice Address - Street 1:4956 DRIFTING PEBBLE ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-3057
Practice Address - Country:US
Practice Address - Phone:702-445-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty