Provider Demographics
NPI:1366754707
Name:THOMAS-JINGLES, CASSANDRA LYNN
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNN
Last Name:THOMAS-JINGLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:LYNN
Other - Last Name:THOMAS-JINGLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:12308 SUGAR MILL DR
Mailing Address - Street 2:
Mailing Address - City:GEISMAR
Mailing Address - State:LA
Mailing Address - Zip Code:70734-3253
Mailing Address - Country:US
Mailing Address - Phone:225-235-5469
Mailing Address - Fax:225-230-1046
Practice Address - Street 1:12097 OLD HAMMOND HWY STE I4
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816
Practice Address - Country:US
Practice Address - Phone:225-330-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06189363L00000X, 363LP0808X
WAAP61540195363LP0808X
NY406995363LP0808X
MDAC005462363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA573112OtherMEDICARE
LA2125354Medicaid