1881371359 NPI number — SARA JO CASHMAN CNP

Table of content: SARA JO CASHMAN CNP (NPI 1881371359)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881371359 NPI number — SARA JO CASHMAN CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASHMAN
Provider First Name:
SARA
Provider Middle Name:
JO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEINERT
Provider Other First Name:
SARA
Provider Other Middle Name:
JO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881371359
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
202 DUNHAM AVE N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESSINGTON SPRINGS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57382-2111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-770-9389
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
602 1ST ST NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESSINGTON SPRINGS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57382-2167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-539-1778
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/28/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  CP002856 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)