Provider Demographics
NPI:1154581429
Name:BANKS, CASSIE MARIE (MS FNP)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:MARIE
Last Name:BANKS
Suffix:
Gender:F
Credentials:MS FNP
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:MARIE
Other - Last Name:THORSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GORDON
Mailing Address - State:NE
Mailing Address - Zip Code:69343-1123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 E 8TH ST
Practice Address - Street 2:
Practice Address - City:GORDON
Practice Address - State:NE
Practice Address - Zip Code:69343-1123
Practice Address - Country:US
Practice Address - Phone:308-282-0401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO167820363LF0000X
NE110982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily