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NPI Code Detail

MEDICARE: JANE R SASSENFELD CNP

MEDICARE: JANE R SASSENFELD CNP
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
1363LW0102XWomen's Health Nurse PractitionerR-1499704MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
240D85HAOTHERMNBLUE CROSS BLUE SHIELD
307-02029OTHERMNMEDICA

General Provider Information

NPI Number : 1922054402
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE R SASSENFELD CNP
Provider Business Mailing Address
First Line : 701 PARK AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55415-1623
Country : US
Telephone Number : 612-873-6005
Fax Number : 612-630-8242
Provider Business Practice Location Address
First Line : 2810 NICOLLET AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-4708
Country : US
Telephone Number : 612-873-6005
Fax Number : 612-630-8242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 10/05/2012

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