Provider Demographics
NPI:1518493212
Name:STENZEL, KAIT
Entity Type:Individual
Prefix:
First Name:KAIT
Middle Name:
Last Name:STENZEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8942 CARRIAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2290
Mailing Address - Country:US
Mailing Address - Phone:651-216-9844
Mailing Address - Fax:
Practice Address - Street 1:8942 CARRIAGE HILL RD
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2290
Practice Address - Country:US
Practice Address - Phone:651-216-9844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNN215133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist