Individual
MARY ANN VANPILSUM-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LRD
Contact information
Practice address
2930 QUENTIN AVE, ST LOUIS PARK, MN 55416-1965
(612) 207-3545
Mailing address
2930 QUENTIN AVE, ST LOUIS PARK, MN 55416-1965
(612) 207-3545
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4172
MN
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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