Provider Demographics
NPI:1174291470
Name:RUHL, KAREN THERESE (RD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:THERESE
Last Name:RUHL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:THERESE
Other - Last Name:EIDEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8109 ASTER DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55428-2124
Mailing Address - Country:US
Mailing Address - Phone:630-886-4607
Mailing Address - Fax:
Practice Address - Street 1:8109 ASTER DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55428-2124
Practice Address - Country:US
Practice Address - Phone:630-886-4607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3677133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered