Provider Demographics
NPI:1053150193
Name:WARNER, CASSIDY LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:LYNN
Last Name:WARNER
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Gender:
Credentials:PA-C
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Mailing Address - Street 1:155 GARLAND ST UNIT 407
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10850 E TRAVERSE HWY STE 1155
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-1363
Practice Address - Country:US
Practice Address - Phone:231-268-0013
Practice Address - Fax:469-319-9379
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2025-02-24
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant