Provider Demographics
NPI:1962214429
Name:RIOS, CASSANDRA L (RN)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:L
Last Name:RIOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 WALL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-3038
Mailing Address - Country:US
Mailing Address - Phone:515-368-4750
Mailing Address - Fax:
Practice Address - Street 1:725 WALL ST
Practice Address - Street 2:
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003-3038
Practice Address - Country:US
Practice Address - Phone:515-368-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2312699163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health