Most Relevant Information
Provider Data
| NPI Number: | 1003556622 |
| Provider Name: | STEFANIE KAITLYN JENSEN RD, LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 86168535 |
Most Important Dates
| Enumeration Date: | 03/31/2022 |
| Last Updated: | 03/31/2022 |
Provider Practice Location
2265 COMO AVE
SAINT PAUL
MN
551081737
Practice Location Phone/Fax
| Phone: | 8883645977 |
| Fax: |
Provider Mailing Location
900 HOYT AVE W
SAINT PAUL
MN
551173301
Provider Mailing Phone/Fax
| Phone: | 5153146079 |
| Fax: |