Individual
DIANE M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LD,CDE
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 467-3948
(612) 727-5997
Mailing address
3685 WINDTREE DR, EAGAN, MN 55123-1320
(651) 456-0181
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1965
MN
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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