Provider Demographics
NPI:1194202507
Name:RAMSTAD, CASSANDRA (RDN)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:RAMSTAD
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4142 39TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-3435
Mailing Address - Country:US
Mailing Address - Phone:612-710-5028
Mailing Address - Fax:
Practice Address - Street 1:4142 39TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-3435
Practice Address - Country:US
Practice Address - Phone:612-710-5028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered