Unknown Individual – Registered Dietitian, NPI 1053371062
Registered Dietitian
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
34th Avenue South, Bloomington, Hennepin County, Minnesota, 55425, United States
MAIL STOP 21110Q
BLOOMINGTON, MN 554251672
Phone: (952) 883-5463
Fax: (952) 883-5395
Type: Mailing
North Highway 61, White Bear Lake, Ramsey County, Minnesota, 55110, United States
MAIL STOP 32300A
WHITE BEAR LAKE, MN 551107693
Phone: (651) 426-1980
Fax: (651) 653-2111
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55425)
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