Provider Demographics
NPI:1629938808
Name:ALDRICH, NOEL DAVID
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:DAVID
Last Name:ALDRICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 3RD ST
Mailing Address - Street 2:
Mailing Address - City:KENYON
Mailing Address - State:MN
Mailing Address - Zip Code:55946-1008
Mailing Address - Country:US
Mailing Address - Phone:651-323-8163
Mailing Address - Fax:
Practice Address - Street 1:158 WATER ST N STE 2
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-2125
Practice Address - Country:US
Practice Address - Phone:651-323-8163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNN211133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education