Healthcare Provider Details

I. General information

NPI: 1215699590
Provider Name (Legal Business Name): CASSANDRA A WOITASZEWSKI RN, BSN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1091 N HIAWATHA AVE
PIPESTONE MN
56164-2286
US

IV. Provider business mailing address

1091 N HIAWATHA AVE
PIPESTONE MN
56164-2286
US

V. Phone/Fax

Practice location:
  • Phone: 507-825-8565
  • Fax: 507-825-6727
Mailing address:
  • Phone: 507-825-8565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number2277873
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: