MEDICARE: SHARON LEHRMAN RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	2417	MN

General Provider Information

NPI Number	:	1053711234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON LEHRMAN RD

Provider Business Mailing Address
First Line	:	2610 VERNON AVE S
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-1708
Country	:	US
Telephone Number	:	952-412-5738
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 VERNON AVE S
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-1708
Country	:	US
Telephone Number	:	952-412-5738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2014
Last Update Date	:	08/25/2014

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Directions to “ SHARON LEHRMAN RD” Practice Location

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