Provider Demographics
NPI:1871993287
Name:ANDREWS, CASSANDRA
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1978
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32050-1978
Mailing Address - Country:US
Mailing Address - Phone:904-861-1034
Mailing Address - Fax:904-861-1037
Practice Address - Street 1:91 BRANSCOMB RD STE 3
Practice Address - Street 2:
Practice Address - City:GREEN COVE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32043-7222
Practice Address - Country:US
Practice Address - Phone:904-861-1034
Practice Address - Fax:904-861-1037
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9293473363LF0000X
FLARNP9293473363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013222400Medicaid
FLIB389YMedicare PIN