Provider Demographics
NPI:1326191305
Name:SIPE, CASSIE T (RD)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:T
Last Name:SIPE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:T
Other - Last Name:SIPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DIETICIAN
Mailing Address - Street 1:6000 US 98
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32512-0001
Mailing Address - Country:US
Mailing Address - Phone:850-505-6223
Mailing Address - Fax:
Practice Address - Street 1:6000 US 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512-0001
Practice Address - Country:US
Practice Address - Phone:850-505-6223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered