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General NPI Number Information
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NPI Number | 1942333992
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Entity Type | Individual
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Provider Name | TAMI MICHELLE CARPENTER RDN, LD, CDE
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 303 E NICOLLET BLVD SUITE 200
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City | BURNSVILLE
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State | MN
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Zip | 55337-4522
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Country | US
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Telephone | 952-460-4013
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Fax |
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Provider Business Mailing Address
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Address Line | 303 E NICOLLET BLVD SUITE 200
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City | BURNSVILLE
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State | MN
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Zip | 55337-4522
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Country | US
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Telephone | 952-460-4013
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Fax |
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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 | 2445
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License Number State | MN
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