Cassandra Lynn Tice, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

733896 Issued in NY

Practice address

120 Canandaigua St
Palmyra, NY 14522-1326

Phone

(315) 597-6609

Fax

(315) 597-3898

NPI assigned

Dec 8, 2020

Last updated

Jan 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1497351241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CANANDAIGUA ST",
            "city": "PALMYRA",
            "state": "NY",
            "postal_code": "145221326",
            "telephone_number": "315-597-6609",
            "fax_number": "315-597-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CANANDAIGUA ST",
            "city": "PALMYRA",
            "state": "NY",
            "postal_code": "145221326",
            "telephone_number": "315-597-6609",
            "fax_number": "315-597-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "CASSANDRA",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "733896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Ann Ross, LPN
• Chester Albert Scerra, O.D.
• Donna Marie Selner, LMHC
• State of New York Comptrollers Office
• Raymond T Sweeney, DDS
• Carrie Marie Titlow, M.A.
• Amy Tones, MSN RN
• Judy L Vanderhoof, RN
• Karensue Vanderlyke, R.N.
• Walgreen Co (Walgreens #19919)

• Registered Nurse in Palmyra, NY
• Providers in Palmyra, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.