Provider Demographics
NPI:1861277030
Name:GILPIN, CASSANDRA C
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:C
Last Name:GILPIN
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 1:225 S PINE ST, JMB, 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274
Mailing Address - Country:US
Mailing Address - Phone:812-523-7466
Mailing Address - Fax:812-523-7471
Practice Address - Street 1:225 S PINE ST, JMB, 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274
Practice Address - Country:US
Practice Address - Phone:812-523-7466
Practice Address - Fax:812-523-7471
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10004331A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant