Mackenzie Dougherty, RD, CD | |
2265 Como Ave, Saint Paul, MN 55108-1737 | |
(651) 645-5323 | |
Not Available |
Full Name | Mackenzie Dougherty |
---|---|
Gender | Female |
Speciality | Dietitian, Registered |
Location | 2265 Como Ave, Saint Paul, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053612283 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
133V00000X | Dietitian, Registered | 3882 (Minnesota) | Primary |
Provider Name | University Of Minnesota Physicians |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1477598118 PECOS PAC ID: 9830001189 Enrollment ID: O20031104000532 |
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 |
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Mackenzie Dougherty, RD, CD 2265 Como Ave, Saint Paul, MN 55108-1737 Ph: () - | Mackenzie Dougherty, RD, CD 2265 Como Ave, Saint Paul, MN 55108-1737 Ph: (651) 645-5323 |
Christina Yokanovich, RD,LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 45 10th St W, Saint Paul, MN 55102 Phone: 651-232-3249 | |
Stefanie Kaitlyn Jensen, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 2265 Como Ave, Saint Paul, MN 55108 Phone: 888-364-5977 | |
Azzairia Jackson, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2081 Village Ln Apt B5, Saint Paul, MN 55116 Phone: 612-735-1669 | |
Tyann Zeal, R.D., L.D. Dietitian Medicare: Medicare Enrolled Practice Location: 2550 University Ave W, Saint Paul, MN 55114 Phone: 952-993-6200 | |
Stephanie K Campbell, Dietitian Medicare: Medicare Enrolled Practice Location: 200 University Ave E, Saint Paul, MN 55101 Phone: 651-229-3933 | |
Deanna Miller, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2265 Como Ave, Saint Paul, MN 55108 Phone: 651-645-5323 Fax: 651-647-5135 | |
Lindsey Stiyer, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2265 Como Ave, Saint Paul, MN 55108 Phone: 651-645-5323 Fax: 561-379-6141 |