Individual
MARYA DAWN WILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LRD
Contact information
Practice address
705 PLEASANT AVE S, ESSENTIA HEALTH PARK RAPIDS CLINIC, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2857
Mailing address
400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC MCL2CRED, DULUTH, MN 55800-1951
(218) 732-2800
(218) 732-2857
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2280
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23627
NDBS #
MN
01
—
34871
LHS/BANNERHEALTH #
MN
01
—
6300246
MEDICA #
MN
01
—
6300247
MEDICA #
MN
01
—
6300248
MEDICA #
MN
01
—
HP39460
HEALTHPARTNERS #
MN
Enumeration date
06/09/2006
Last updated
03/13/2018
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