Provider Demographics
NPI:1073930715
Name:KASPER, SARAH (RN, CNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KASPER
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:KINDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2100 3RD AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-2235
Mailing Address - Country:US
Mailing Address - Phone:763-422-7030
Mailing Address - Fax:763-422-6988
Practice Address - Street 1:2100 3RD AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2235
Practice Address - Country:US
Practice Address - Phone:763-422-7030
Practice Address - Fax:763-422-6988
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 175107-3163W00000X
MNAG0214084363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse