Provider Demographics
NPI:1225833460
Name:CRUMPTON, CASSANDRA LOIS
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LOIS
Last Name:CRUMPTON
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 ANTELOPE TRL
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:WY
Mailing Address - Zip Code:82941-9026
Mailing Address - Country:US
Mailing Address - Phone:307-705-8345
Mailing Address - Fax:
Practice Address - Street 1:219 E PINE ST APT 201
Practice Address - Street 2:
Practice Address - City:PINEDALE
Practice Address - State:WY
Practice Address - Zip Code:82941-5350
Practice Address - Country:US
Practice Address - Phone:307-734-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program