Provider Demographics
NPI:1982981965
Name:TATE, CASSANDRA (RN)
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:
Last Name:TATE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 KILDARE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2932
Mailing Address - Country:US
Mailing Address - Phone:216-397-1201
Mailing Address - Fax:216-927-3746
Practice Address - Street 1:3301 KILDARE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2932
Practice Address - Country:US
Practice Address - Phone:216-397-1201
Practice Address - Fax:216-927-3746
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.193622163W00000X, 163WC0200X, 163WG0600X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical