Doctor Name: | MARY JO BRUNNER |
NPI Number: | 1073535399 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, LD |
License Number: | 2563 |
Business Practice Address: | 7180 10th St N Oakdale, MN - 551281122 |
Business Phone Number: | 6517143160 |
Business Fax Number: | 6517350070 |
Mailing Address: | 7180 10th St N, OAKDALE |
State: | MN |
Postal Code: | 551281122 |
Phone Number: | 6517143160 |
Fax Number: | 6517350070 |
NPI Enumeration Date: | 07/24/2006 |
NPI Last Update Date: | 10/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 2563 |
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 |