Provider Demographics
NPI:1154152395
Name:COLON, CASSANDRA JNE (RN)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JNE
Last Name:COLON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 ROMANTICA DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29527-6280
Mailing Address - Country:US
Mailing Address - Phone:843-424-2512
Mailing Address - Fax:
Practice Address - Street 1:2501 ROMANTICA DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29527-6280
Practice Address - Country:US
Practice Address - Phone:843-424-2512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program