Provider Demographics
NPI:1326114265
Name:STEELE, MARY KAY (RD, LD, CDE)
Entity Type:Individual
Prefix:
First Name:MARY KAY
Middle Name:
Last Name:STEELE
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 1:6322 LOWER 161 ST W
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-1211
Mailing Address - Country:US
Mailing Address - Phone:952-997-6047
Mailing Address - Fax:612-863-8927
Practice Address - Street 1:800 E 28 ST
Practice Address - Street 2:MR 11414
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3799
Practice Address - Country:US
Practice Address - Phone:612-863-8934
Practice Address - Fax:612-863-8927
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2260133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered