Provider Demographics
NPI:1245240472
Name:MCCRONE, VESTISHA ANNE (CST)
Entity Type:Individual
Prefix:
First Name:VESTISHA
Middle Name:ANNE
Last Name:MCCRONE
Suffix:
Gender:F
Credentials:CST
Other - Prefix:
Other - First Name:VESTISHA
Other - Middle Name:ANNE
Other - Last Name:HENDERSON, RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CST
Mailing Address - Street 1:6465 WAYZATA BLVD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1728
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5650
Practice Address - Street 1:3366 OAKDALE AVE N
Practice Address - Street 2:SUITE 103
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2948
Practice Address - Country:US
Practice Address - Phone:763-520-7870
Practice Address - Fax:763-520-7580
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other