Provider Demographics
NPI:1467676288
Name:KORBEL, LILA (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:LILA
Middle Name:
Last Name:KORBEL
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 W 280TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-8873
Mailing Address - Country:US
Mailing Address - Phone:507-332-4736
Mailing Address - Fax:
Practice Address - Street 1:200 STATE AVE
Practice Address - Street 2:DISTRICT ONE HOSPITAL
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-6339
Practice Address - Country:US
Practice Address - Phone:507-332-4736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1196133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered