Provider Demographics
NPI:1023757671
Name:AHLERT, LINDSEY (RD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:AHLERT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:21377 TUNGSTEN ST NW
Mailing Address - Street 2:
Mailing Address - City:NOWTHEN
Mailing Address - State:MN
Mailing Address - Zip Code:55303-8500
Mailing Address - Country:US
Mailing Address - Phone:715-821-1112
Mailing Address - Fax:
Practice Address - Street 1:21377 TUNGSTEN ST NW
Practice Address - Street 2:
Practice Address - City:NOWTHEN
Practice Address - State:MN
Practice Address - Zip Code:55303-8500
Practice Address - Country:US
Practice Address - Phone:715-821-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3069133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered