Elise Frances Bartelds, RD, LD | |
17398 Eastwood Ave, Lakeville, MN 55044-4826 | |
(612) 618-3123 | |
Not Available |
Full Name | Elise Frances Bartelds |
---|---|
Gender | Female |
Speciality | Dietitian, Registered |
Location | 17398 Eastwood Ave, Lakeville, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922647965 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Provider Name | Emily Program Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1528165065 PECOS PAC ID: 5193623254 Enrollment ID: O20031229000014 |
Mailing Address | Practice Location Address |
---|---|
Elise Frances Bartelds, RD, LD 608 Crystal Lake Rd E, Burnsville, MN 55306-5125 Ph: (612) 618-3123 | Elise Frances Bartelds, RD, LD 17398 Eastwood Ave, Lakeville, MN 55044-4826 Ph: (612) 618-3123 |
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