Individual
JENNIFER LEE STANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
Mailing address
400 E 3RD ST # 6AV1, DULUTH, MN 55805-1951
(218) 829-2861
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3873
MN
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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