Provider Demographics
NPI:1992776561
Name:LEATE, CASSANDRA MELANIE (DNP, RN, ANP, ACNS)
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:MELANIE
Last Name:LEATE
Suffix:
Gender:F
Credentials:DNP, RN, ANP, ACNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 DUNBAR CT
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-6432
Mailing Address - Country:US
Mailing Address - Phone:321-578-1837
Mailing Address - Fax:
Practice Address - Street 1:2110 N GALLOWAY AVE STE 116
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5737
Practice Address - Country:US
Practice Address - Phone:469-898-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1176213163W00000X
VA0024171794363LA2200X
VA0015001083364SA2200X
TX1112406363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health