NPI 1649330176 · live from the CMS NPI Registry
Mary Jo Ambroz, RD
Dietitian, Registered in Brainerd, MN. National Provider Identifier 1649330176, active.
NPI record
| NPI | 1649330176 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 523 N 3rd St, Brainerd, MN 56401 |
| Practice phone | 218-828-7378 |
| Enumerated | December 12, 2006 |
| Last updated | September 18, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 1536 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.