MEDICARE: FEMRITE FAMILY NUTRITION, INC.

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	2182	MN

General Provider Information

NPI Number	:	1861437246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEMRITE FAMILY NUTRITION, INC.

Provider Business Mailing Address
First Line	:	1706 LOR RAY DR
Second Line	:
City	:	NORTH MANKATO
State	:	MN
Zip	:	56003-1939
Country	:	US
Telephone Number	:	507-388-7744
Fax Number	:	507-388-8001

Provider Business Practice Location Address
First Line	:	1706 LOR RAY DR
Second Line	:
City	:	NORTH MANKATO
State	:	MN
Zip	:	56003-1939
Country	:	US
Telephone Number	:	507-388-7744
Fax Number	:	507-388-8001

Authorized Official
Title or Position	:	CEO
Name	:	MRS. JENNIFER M FEMRITE
Credential	:	R.D., L.D.
Telephone Number	:	507-388-7744

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	08/22/2020

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