MEDICARE: CASSANDRA RAMSTAD RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1194202507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA RAMSTAD RDN

Provider Business Mailing Address
First Line	:	4142 39TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3435
Country	:	US
Telephone Number	:	612-710-5028
Fax Number	:

Provider Business Practice Location Address
First Line	:	4142 39TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3435
Country	:	US
Telephone Number	:	612-710-5028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2018
Last Update Date	:	07/27/2018

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