Provider Demographics
NPI:1558752394
Name:MURDY, KARI ANN (RD)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:ANN
Last Name:MURDY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:ANN
Other - Last Name:YOREK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5779 COUNTY ROAD 7 SW
Mailing Address - Street 2:
Mailing Address - City:HOWARD LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55349-5206
Mailing Address - Country:US
Mailing Address - Phone:763-442-2409
Mailing Address - Fax:
Practice Address - Street 1:9680 TAMARACK RD STE 130
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2617
Practice Address - Country:US
Practice Address - Phone:651-265-7575
Practice Address - Fax:651-265-7580
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3493133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered