Provider Demographics
NPI:1013536713
Name:HARPELL, BRANDIE ESTHER (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:BRANDIE
Middle Name:ESTHER
Last Name:HARPELL
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 HARRIET AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3729
Mailing Address - Country:US
Mailing Address - Phone:763-464-7944
Mailing Address - Fax:
Practice Address - Street 1:5825 SAINT CROIX AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55422-4419
Practice Address - Country:US
Practice Address - Phone:612-405-5301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4232133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
86082539OtherCOMMISSION ON DIETETIC REGISTRATION
MN4232OtherMINNESOTA BOARD OF NUTRITION AND DIETETICS LICENSE