Provider Demographics
NPI:1427325885
Name:CARGILL, ANASTASIA A (LPN)
Entity type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:A
Last Name:CARGILL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 OAKWOOD DR
Mailing Address - Street 2:144
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-1974
Mailing Address - Country:US
Mailing Address - Phone:914-837-3181
Mailing Address - Fax:
Practice Address - Street 1:9 OAKWOOD DR
Practice Address - Street 2:144
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-1974
Practice Address - Country:US
Practice Address - Phone:914-837-3181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY298614-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse