Provider Demographics
NPI:1225160542
Name:RUBIN, KAREN (RD LD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 EAST 24TH ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3827
Mailing Address - Country:US
Mailing Address - Phone:612-336-5000
Mailing Address - Fax:612-775-9800
Practice Address - Street 1:710 EAST 24TH ST
Practice Address - Street 2:SUITE 405
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3827
Practice Address - Country:US
Practice Address - Phone:612-336-5000
Practice Address - Fax:612-775-9800
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNR352629OtherRD LICENSE
MN1297OtherSTATE LICENSE
MNR352629OtherRD LICENSE