Individual
TIFFANY FLATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LN, CNS
Contact information
Practice address
9201 QUADAY AVE NE STE 205, OTSEGO, MN 55330-6604
(763) 703-6962
(651) 222-9727
Mailing address
4655 LANNON AVE NE, SAINT MICHAEL, MN 55376-4613
(763) 300-4816
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871909242
—
MN
Enumeration date
07/07/2014
Last updated
09/12/2019
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