Provider Demographics
NPI:1154051316
Name:JUNTUNEN, CASSANDRA SUE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:SUE
Last Name:JUNTUNEN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:SUE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:360 117TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-2382
Mailing Address - Country:US
Mailing Address - Phone:763-742-2876
Mailing Address - Fax:
Practice Address - Street 1:1850 BEAM AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1162
Practice Address - Country:US
Practice Address - Phone:651-241-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-12
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily