Provider Demographics
NPI:1588319743
Name:COLLETT, CASSAUNDRA HELEN FEE (FNP)
Entity type:Individual
Prefix:
First Name:CASSAUNDRA
Middle Name:HELEN FEE
Last Name:COLLETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910866
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0866
Mailing Address - Country:US
Mailing Address - Phone:859-792-1420
Mailing Address - Fax:
Practice Address - Street 1:119 LYNNE DR
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1267
Practice Address - Country:US
Practice Address - Phone:606-594-7541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017321363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1136675OtherKENTUCKY BOARD OF NURSING - RN LICENSE