Provider Demographics
NPI:1962245613
Name:FIELDS, CASSANDRA (FNP-BC)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:FIELDS
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 1:275 W WISCONSIN AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53203-3301
Mailing Address - Country:US
Mailing Address - Phone:205-907-3741
Mailing Address - Fax:
Practice Address - Street 1:4643 ROSSER FARMS PKWY
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-5503
Practice Address - Country:US
Practice Address - Phone:205-907-3741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2024003845363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily