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Organization

LIFE STAGE NUTRITION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KYLE ROBERT ANDERSON MS, RD, LD (FOUNDER)
(651) 243-0924
Entity
Organization

Contact information

Practice address
17450 GETTYSBURG WAY, LAKEVILLE, MN 55044-4006
(651) 243-0924
Mailing address
310 1/2 MAIN ST S, STILLWATER, MN 55082-5126
(651) 243-0924

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian

Other

Enumeration date
01/07/2026
Last updated
02/05/2026
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