Individual
KASSONDRA JO NORDMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2211 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1350
(612) 330-1108
Mailing address
2211 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1350
(612) 330-1108
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2255
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255
STATE OF MINNESOTA BOARD OF MEDICAL PRACTICE
MN
Enumeration date
05/30/2013
Last updated
12/03/2014
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