Cassandra Irene Vajda, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R154214-3 Issued in MN

Practice address

1900 Centra Care Cir #2300
Centracare Clinic - Women's & Childrens
St Cloud, MN 56303-5000

Phone

(320) 654-3610

NPI assigned

May 22, 2006

Last updated

Aug 30, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Cassandra Irene Lundin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Centracare Clinic

  dba CentraCare - St. Joseph Clinic

  • Multi-Specialty Clinic/Center
  • Saint Joseph, MN
  • NPI 1134121759
  NPD (past)
• Centracare Clinic

  dba CentraCare - Plaza Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD (past)
• Child and Teen Medical Center

  • Pediatrics Physician
  • Blaine, MN
  • NPI 1225158520
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1508810540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRA CARE CIR #2300",
            "address_2": "CENTRACARE CLINIC - WOMEN'S & CHILDRENS",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRA CARE CIR #2300",
            "address_2": "CENTRACARE CLINIC - WOMEN'S & CHILDRENS",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAJDA",
        "first_name": "CASSANDRA",
        "middle_name": "IRENE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R154213",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R154214-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "LUNDIN",
            "middle_name": "IRENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatric Nurse Practitioner in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.