Provider Demographics
NPI:1861939241
Name:GAVE, CASSANDRA (DNP APRN CNP)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:GAVE
Suffix:
Gender:F
Credentials:DNP APRN CNP
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP APRN CNP
Mailing Address - Street 1:3850 PARK NICOLLET BLVD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2527
Mailing Address - Country:US
Mailing Address - Phone:952-993-3700
Mailing Address - Fax:952-993-1750
Practice Address - Street 1:3850 PARK NICOLLET BLVD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2527
Practice Address - Country:US
Practice Address - Phone:952-993-3700
Practice Address - Fax:952-993-1750
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP5321363L00000X
MN5321363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner