Provider Demographics
NPI:1366953291
Name:PRICE, CASSANDRA T (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:T
Last Name:PRICE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 SPARTA HWY
Mailing Address - Street 2:
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-8492
Mailing Address - Country:US
Mailing Address - Phone:706-485-8495
Mailing Address - Fax:706-485-8450
Practice Address - Street 1:132 SPARTA HWY
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-8492
Practice Address - Country:US
Practice Address - Phone:706-485-8495
Practice Address - Fax:706-485-8450
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN271892363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN271892OtherGEORGIA STATE LICENSE