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Individual

DR. STACEY JASSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
711 KASOTA AVE SE, MINNEAPOLIS, MN 55414-2842
(612) 669-9437
Mailing address
711 KASOTA AVE SE, MINNEAPOLIS, MN 55414-2842
(612) 669-9437

Taxonomy

Speciality
Code
Description
License number
State
1835N1003X
Nutrition Support Pharmacist
114588
MN
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
114588
MN

Other

Enumeration date
02/20/2010
Last updated
10/08/2012
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