Individual
CASSANDRA TIEDTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Mailing address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
R 199671-5
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
1859
MN
Other
Enumeration date
10/03/2015
Last updated
10/03/2018
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