| Doctor Name: | KATHERINE M CARLSON |
| NPI Number: | 1023253069 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD |
| License Number: | 2780 |
| Business Practice Address: | 6200 Shingle Creek Pkwy Ste 300 Brooklyn Center, MN - 554302128 |
| Business Phone Number: | 7637469010 |
| Business Fax Number: | 7637469022 |
| Mailing Address: | 5117 Drew Ave S, MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554102028 |
| Phone Number: | 7637469010 |
| Fax Number: | 7637469022 |
| NPI Enumeration Date: | 12/04/2008 |
| NPI Last Update Date: | 12/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1005X |
| License Number: | 2780 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Renal |
| Taxonomy Definition: | |