MEDICARE: EMILY WEBER RDN, LD, CWHC

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	3560	MN

General Provider Information

NPI Number	:	1538773528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY WEBER RDN, LD, CWHC

Provider Business Mailing Address
First Line	:	5400 SHOREVIEW AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55417-1918
Country	:	US
Telephone Number	:	651-399-3060
Fax Number	:

Provider Business Practice Location Address
First Line	:	5400 SHOREVIEW AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55417-1918
Country	:	US
Telephone Number	:	651-399-3060
Fax Number	:

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

Provider Enumeration Date	:	09/07/2020
Last Update Date	:	09/07/2020

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