Individual
ERIN CONNELLY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
715 S 8TH ST, MINNEAPOLIS, MN 55404-1210
(612) 873-6963
Mailing address
3024 GETTYSBURG AVE N, NEW HOPE, MN 55427-2307
(952) 221-9526
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3216
MN
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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