Individual
ELLIE LYNN CROAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
12161 63RD ST NE, ALBERTVILLE, MN 55301-4627
(612) 709-3491
Mailing address
6782 LAKEVIEW CIR # A, CORCORAN, MN 55340-9798
(612) 709-3491
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
MN
Other
Enumeration date
06/07/2020
Last updated
05/13/2025
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