Provider Demographics
NPI:1730824665
Name:CASSELL, CHRISSA FAITH
Entity type:Individual
Prefix:
First Name:CHRISSA
Middle Name:FAITH
Last Name:CASSELL
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 1:100 LAMBERT ADDITION RD
Mailing Address - Street 2:
Mailing Address - City:ARBOVALE
Mailing Address - State:WV
Mailing Address - Zip Code:24915-5482
Mailing Address - Country:US
Mailing Address - Phone:304-621-5934
Mailing Address - Fax:
Practice Address - Street 1:100 LAMBERT ADDITION RD
Practice Address - Street 2:
Practice Address - City:ARBOVALE
Practice Address - State:WV
Practice Address - Zip Code:24915-5482
Practice Address - Country:US
Practice Address - Phone:304-621-5934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemaker
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty