Provider Demographics
NPI:1417754573
Name:BALANDRAN, KASSANDRA MARIE
Entity type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:MARIE
Last Name:BALANDRAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-2219
Mailing Address - Country:US
Mailing Address - Phone:308-249-2631
Mailing Address - Fax:
Practice Address - Street 1:925 10TH AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-1609
Practice Address - Country:US
Practice Address - Phone:308-249-0718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant