| Doctor Name: | VIRGINIA L BENNETT |
| NPI Number: | 1033172036 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, RD, LD |
| License Number: | 1018 |
| Business Practice Address: | 1540 Lake St S Forest Lake, MN - 550252628 |
| Business Phone Number: | 6514647100 |
| Business Fax Number: | 6519825515 |
| Mailing Address: | Po Box 43, Mr 10809 MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554400043 |
| Phone Number: | 6122624813 |
| Fax Number: | 6122624194 |
| NPI Enumeration Date: | 04/10/2006 |
| NPI Last Update Date: | 11/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 1018 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |