Provider Demographics
NPI:1295456572
Name:CROSS, CASSANDRA LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNN
Last Name:CROSS
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:604 CEDAR STREET EXT
Mailing Address - Street 2:
Mailing Address - City:BLUFF CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37618-2917
Mailing Address - Country:US
Mailing Address - Phone:423-444-5469
Mailing Address - Fax:
Practice Address - Street 1:604 CEDAR STREET EXT
Practice Address - Street 2:
Practice Address - City:BLUFF CITY
Practice Address - State:TN
Practice Address - Zip Code:37618-2917
Practice Address - Country:US
Practice Address - Phone:423-444-5469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant