Healthcare Provider Details

I. General information

NPI: 1639910128
Provider Name (Legal Business Name): HOLLY HUHLEIN REGISTERED DIETITIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 WEST 66TH STREET UNIT 548
EDINA MN
55435-5514
US

IV. Provider business mailing address

905 FORREST HEIGHTS DR SE
HUNTSVILLE AL
35802-3740
US

V. Phone/Fax

Practice location:
  • Phone: 651-447-6737
  • Fax:
Mailing address:
  • Phone: 256-529-7079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number5270
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: