Provider Demographics
NPI:1962248575
Name:FANCHER, CASSANDRA ELIZABETH (ARNP)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ELIZABETH
Last Name:FANCHER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 W HOOD PL STE A101
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-6720
Mailing Address - Country:US
Mailing Address - Phone:509-581-3100
Mailing Address - Fax:509-436-1948
Practice Address - Street 1:7101 W HOOD PL STE A101
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-6720
Practice Address - Country:US
Practice Address - Phone:509-581-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61575967363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner