Provider Demographics
NPI:1114042876
Name:BISPALA, BARBARA T (RD,LD,CDE)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:T
Last Name:BISPALA
Suffix:
Gender:F
Credentials:RD,LD,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DELLWOOD ST S
Mailing Address - Street 2:CAMBRIDGE MEDICAL CENTER-NUTRITION AND FOOD SERVICES
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-1920
Mailing Address - Country:US
Mailing Address - Phone:763-691-1416
Mailing Address - Fax:
Practice Address - Street 1:701 DELLWOOD ST S
Practice Address - Street 2:CAMBRIDGE MEDICAL CENTER-NUTRITION AND FOOD SERVICES
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-1920
Practice Address - Country:US
Practice Address - Phone:763-689-7700
Practice Address - Fax:763-689-7878
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1555133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered