Individual
JANE R SASSENFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R-1499704
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-02029
MEDICA
MN
01
—
40D85HA
BLUE CROSS BLUE SHIELD
MN
05
—
981472800
—
MN
Enumeration date
05/26/2006
Last updated
10/05/2012
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