Healthcare Provider Details

I. General information

NPI: 1225943285
Provider Name (Legal Business Name): JESSIE M ZINS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12400 OPAL ST NE
BLAINE MN
55449-6433
US

IV. Provider business mailing address

12400 OPAL ST NE
BLAINE MN
55449-6433
US

V. Phone/Fax

Practice location:
  • Phone: 612-360-3888
  • Fax:
Mailing address:
  • Phone: 612-360-3888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: