Provider Demographics
NPI:1063064947
Name:CAUSEY, KASANDRA M
Entity type:Individual
Prefix:MS
First Name:KASANDRA
Middle Name:M
Last Name:CAUSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 BANCROFT ST
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721
Mailing Address - Country:US
Mailing Address - Phone:231-420-2392
Mailing Address - Fax:
Practice Address - Street 1:1529 BANCROFT ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-1301
Practice Address - Country:US
Practice Address - Phone:231-420-2392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide