Individual
CAROLYN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2200 UNIVERSITY AVE W STE 120, SAINT PAUL, MN 55114-1844
(612) 870-5557
(612) 870-5491
Mailing address
PO BOX 14909, MINNEAPOLIS, MN 55414-0909
(612) 871-1145
(612) 870-5491
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3178
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3178
MN BORAD OF DIETETICS AND NUTRITION PRACTICE
MN
Enumeration date
12/23/2013
Last updated
03/07/2016
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