NPI 1740403393 · live from the CMS NPI Registry
Adult Medicine PA
Dietitian, Registered in Saint Paul, MN. National Provider Identifier 1740403393, active.
NPI record
| NPI | 1740403393 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 393 Dunlap St N Ste 235, Saint Paul, MN 55104 |
| Practice phone | 651-644-7775 |
| Enumerated | April 11, 2007 |
| Last updated | September 11, 2025 |
| Authorized official | Kimberly Anderson-Uzpen, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine | 207R00000X | 26646 (MN) |
| Dietitian, Registered primary | 133V00000X | N153 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.