Individual
JILL MARIA BREYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
HWY 1, REDLAKE, MN 56671-0497
(218) 679-3912
(218) 679-0181
Mailing address
PO BOX 497, REDLAKE, MN 56671-0497
(218) 679-3912
(218) 679-0181
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2050
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2050
DIETETICS
MN
Enumeration date
11/20/2006
Last updated
01/22/2008
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