Provider Demographics
NPI:1720869522
Name:REDFERN, CASSANDRA LYNN (MS, RDN, CPT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNN
Last Name:REDFERN
Suffix:
Gender:F
Credentials:MS, RDN, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 STERLING HILL RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825-7508
Mailing Address - Country:US
Mailing Address - Phone:603-540-7823
Mailing Address - Fax:
Practice Address - Street 1:27 ALBANY ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4976
Practice Address - Country:US
Practice Address - Phone:603-703-3643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH86278237133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered