Cassie Barczak

Individual provider Active NPI Licensed Practical Nurse · Conneaut, OH

NPI 1043696644 · NPPES record last updated Dec 18, 2015

Key facts

NPI
1043696644
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN.145513-M-IV (OH)
Practice address
976 Broad St
Conneaut, OH 44030-1556
Phone
(440) 599-2620
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN.145513-M-IVOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.145513-M-IV OH Yes

Addresses

Primary practice location

976 Broad St
Conneaut, OH 44030-1556

Mailing address

976 Broad St
Conneaut, OH 44030-1556

Other providers in Conneaut, OH

All providers in Conneaut, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.