Individual
MS. JEANIE LYNN BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
500 OSBORNE RD NE, SUITE 200, FRIDLEY, MN 55432-2765
(763) 236-2045
Mailing address
55 W 96TH ST APT 3L, BLOOMINGTON, MN 55420-4357
(651) 895-7832
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2581
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
962256
ADA REGISTRATION NUMBER
—
Enumeration date
11/30/2006
Last updated
07/08/2007
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