Individual
KATHERINE J ELLEFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,CD
Contact information
Practice address
6625 LYNDALE AVE S STE 430, RICHFIELD, MN 55423-2300
(952) 285-2840
Mailing address
1146 RIVER RD, DRESSER, WI 54009-4203
(715) 417-1705
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2694-29
WI
133V00000X
Registered Dietitian
Primary
3236
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1055136
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
10/17/2014
Last updated
11/19/2020
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