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General NPI Number Information
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NPI Number | 1851879159
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Entity Type | Individual
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Provider Name | CASSANDRA HAFFNER
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Gender | Female
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 1 N COLLEGE ST
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City | NORTHFIELD
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State | MN
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Zip | 55057-4001
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Country | US
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Telephone | 507-222-7371
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 250TH ST W
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City | FARMINGTON
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State | MN
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Zip | 55024-9648
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2731
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License Number State | MN
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