Provider Demographics
NPI:1518841139
Name:DARDEN, CASSANDRA KELLI
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:KELLI
Last Name:DARDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:KELLI
Other - Last Name:DARDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:103 BROOKMONT DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-8812
Mailing Address - Country:US
Mailing Address - Phone:919-809-8002
Mailing Address - Fax:919-809-8002
Practice Address - Street 1:1201 AVERSBORO RD STE H201
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4395
Practice Address - Country:US
Practice Address - Phone:919-809-8002
Practice Address - Fax:984-200-0288
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care