Provider Demographics
NPI:1174067292
Name:MCMASTER, CASSANDRA (RN)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:MCMASTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:DURGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1901
Mailing Address - Country:US
Mailing Address - Phone:617-633-5703
Mailing Address - Fax:
Practice Address - Street 1:1800 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-1042
Practice Address - Country:US
Practice Address - Phone:617-442-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN276145163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse