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General NPI Number Information
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NPI Number | 1689247660
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Entity Type | Individual
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Provider Name | MEGAN INGEBRETSON RD
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Gender | Female
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 3960 COON RAPIDS BLVD NW STE 220
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City | COON RAPIDS
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State | MN
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Zip | 55433-2589
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Country | US
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Telephone | 763-236-8438
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Fax | 763-427-1787
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Provider Business Mailing Address
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Address Line | PO BOX 43
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City | MINNEAPOLIS
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State | MN
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Zip | 55440-0043
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Country | US
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Telephone | 612-262-1166
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Fax | 612-262-4258
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86143840
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License Number State | MN
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