Provider Demographics
NPI:1316257868
Name:EVERETT, KASSANDRA NICOLE (DC)
Entity type:Individual
Prefix:DR
First Name:KASSANDRA
Middle Name:NICOLE
Last Name:EVERETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KASSANDRA
Other - Middle Name:NICOLE
Other - Last Name:BROWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1201 N DOUGLASS ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MO
Mailing Address - Zip Code:63863-1351
Mailing Address - Country:US
Mailing Address - Phone:573-276-3892
Mailing Address - Fax:573-276-3893
Practice Address - Street 1:1201 N DOUGLASS ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MO
Practice Address - Zip Code:63863-1351
Practice Address - Country:US
Practice Address - Phone:573-276-3892
Practice Address - Fax:573-276-3893
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010014270111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor