Provider Demographics
NPI:1023879525
Name:MIHM, KRISTEN (MPH, RD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:MIHM
Suffix:
Gender:F
Credentials:MPH, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 MORGAN LN
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-5512
Mailing Address - Country:US
Mailing Address - Phone:651-357-0528
Mailing Address - Fax:
Practice Address - Street 1:126 MORGAN LN
Practice Address - Street 2:
Practice Address - City:LINO LAKES
Practice Address - State:MN
Practice Address - Zip Code:55014-5512
Practice Address - Country:US
Practice Address - Phone:651-357-0528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered