Provider Demographics
NPI:1447606868
Name:COLLETT, KARI (RDN, LDN, CLT)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:COLLETT
Suffix:
Gender:F
Credentials:RDN, LDN, CLT
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:
Other - Last Name:SHOLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 ELM ST. N
Mailing Address - Street 2:
Mailing Address - City:ONAMIA
Mailing Address - State:MN
Mailing Address - Zip Code:56359-0807
Mailing Address - Country:US
Mailing Address - Phone:320-532-3154
Mailing Address - Fax:320-532-3111
Practice Address - Street 1:200 ELM ST N
Practice Address - Street 2:
Practice Address - City:ONAMIA
Practice Address - State:MN
Practice Address - Zip Code:56359-0807
Practice Address - Country:US
Practice Address - Phone:320-532-3154
Practice Address - Fax:320-532-2957
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3691133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered