Provider Demographics
NPI:1922844836
Name:HINERMAN, CASSANDRA LYNN
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNN
Last Name:HINERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:LYNN
Other - Last Name:PRESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1302 WESTERN ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-3263
Mailing Address - Country:US
Mailing Address - Phone:620-215-0897
Mailing Address - Fax:
Practice Address - Street 1:1302 WESTERN ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-3263
Practice Address - Country:US
Practice Address - Phone:620-215-0897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS123217163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse