Healthcare Provider Details

I. General information

NPI: 1073296018
Provider Name (Legal Business Name): JOSEPHINE ANNE KUGLER MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 S CASCADE ST
FERGUS FALLS MN
56537-2913
US

IV. Provider business mailing address

712 S CASCADE ST
FERGUS FALLS MN
56537-2913
US

V. Phone/Fax

Practice location:
  • Phone: 218-736-8059
  • Fax: 218-736-8727
Mailing address:
  • Phone: 218-736-8059
  • Fax: 218-736-8727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number5022
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: