Provider Demographics
NPI:1902822372
Name:KORZENIOWSKI, JANET KAY (RD, LD, CDE)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:KAY
Last Name:KORZENIOWSKI
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12434 95TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-4509
Mailing Address - Country:US
Mailing Address - Phone:320-632-1202
Mailing Address - Fax:320-632-1354
Practice Address - Street 1:815 2ND ST SE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3505
Practice Address - Country:US
Practice Address - Phone:320-632-1202
Practice Address - Fax:320-632-1354
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1661133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered