Provider Demographics
NPI:1538548243
Name:DAVIS, KASSANDRA MEGHAN (MD)
Entity type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:MEGHAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KASSANDRA
Other - Middle Name:
Other - Last Name:CONNEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:P.O. BOX 2290
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848
Mailing Address - Country:US
Mailing Address - Phone:308-865-2767
Mailing Address - Fax:308-865-2765
Practice Address - Street 1:620 EAST 25TH STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:KEARNY
Practice Address - State:NE
Practice Address - Zip Code:68847-5511
Practice Address - Country:US
Practice Address - Phone:402-559-5641
Practice Address - Fax:402-559-6501
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE29644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine