Larsen, Cassondra Marie
Larsen, Cassondra Marie is an individual health care provider with primary practice located at 1165 Imperial Dr Ste 300 , Hagerstown MD 21740-6556. She recently has only one registered license in Other Service Providers / Midwife, which is considered as her primary health care specialty. Larsen, Cassondra Marie can be contacted via phone (301) 665-9098.Contact Information
Primary practice address
1165 Imperial Dr Ste 300
Hagerstown MD 21740-6556
Phone: (301) 665-9098
Fax: (301) 665-9096
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Midwife | 176B00000X | R201221 | Maryland |
Profile Details
| NPI number | 1992323604 |
|---|---|
| LBN Legal business name | Larsen, Cassondra Marie |
| Credentials | Certified Nurse Midwife (CNM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2020 |
| Last updated | Nov 2nd, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992323604 | NPPES |
| Maryland | Other | R201221 | LICENSE |
| Maryland | MEDICAID | ASC-197Z | LICENSE |
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