Provider Demographics
NPI:1730910027
Name:BUFFINGTON, CASSANDRA SHEA
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:SHEA
Last Name:BUFFINGTON
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:SHEA
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204 S RIVERFRONT DR
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-3901
Mailing Address - Country:US
Mailing Address - Phone:573-836-4272
Mailing Address - Fax:
Practice Address - Street 1:5310 E 31ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5012
Practice Address - Country:US
Practice Address - Phone:918-600-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator