CASSIDY LORRAINE DUCRAY NPI 1144929084

NPI Information

NPI: 1144929084
Provider Name: CASSIDY LORRAINE DUCRAY
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1142 E SOUTHERN AVE
MESA, AZ
ZIP 85204
Phone: (480) 821-3628
Get Directions

Cassidy Lorraine Ducray is a family nurse practitioner in Mesa, AZ. Cassidy Lorraine Ducray NPI is 1144929084. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1142 E SOUTHERN AVE
MESA, AZ
ZIP 85204-055
Phone: (480) 821-3628

The NPI 1144929084 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/28/2023 and was last updated on 12/29/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology	TEMP288504	ARIZONA	No
2	363LF0000X	Nurse Practitioner	Family	288504	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	016545	MEDICAID	ARIZONA
2	TEMP288504	OTHER	ARIZONA	FNP LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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