Provider Demographics
NPI:1588628135
Name:RAMIREZ, JASMIN GRACE VALERA (RD LD CDE)
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:GRACE VALERA
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RD LD CDE
Other - Prefix:
Other - First Name:JASMIN
Other - Middle Name:GRACE PAGUYO
Other - Last Name:VALERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD LD
Mailing Address - Street 1:7701 YORK AVE S
Mailing Address - Street 2:SUITE 180
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5845
Mailing Address - Country:US
Mailing Address - Phone:952-927-7810
Mailing Address - Fax:952-927-6309
Practice Address - Street 1:7701 YORK AVE S
Practice Address - Street 2:SUITE 180
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5845
Practice Address - Country:US
Practice Address - Phone:952-927-7810
Practice Address - Fax:952-927-6309
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2364133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP41069OtherHEALTH PARTNERS
MN710000393Medicare ID - Type Unspecified