Healthcare Provider Details

I. General information

NPI: 1992250187
Provider Name (Legal Business Name): ERIN ZIOLKOWSKI RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 UNIVERSITY AVE W
SAINT PAUL MN
55114-1052
US

IV. Provider business mailing address

550 OSBORNE RD NE
FRIDLEY MN
55432-2718
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-6200
  • Fax:
Mailing address:
  • Phone: 763-236-2045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3729
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: