NPI 1104783406 · live from the CMS NPI Registry
Kyle Robert Anderson, MS, RD, LD
Dietitian, Registered in Stillwater, MN. National Provider Identifier 1104783406, active.
NPI record
| NPI | 1104783406 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 310 1/2 Main St S, Stillwater, MN 55082 |
| Practice phone | 651-243-0924 |
| Enumerated | January 7, 2026 |
| Last updated | February 5, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 3767 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.