Provider Demographics
NPI:1972529766
Name:SCHWEIM, AUDRA MAE (RD)
Entity Type:Individual
Prefix:MRS
First Name:AUDRA
Middle Name:MAE
Last Name:SCHWEIM
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 NORTHRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-1632
Mailing Address - Country:US
Mailing Address - Phone:507-388-5597
Mailing Address - Fax:
Practice Address - Street 1:1627 NORTHRIDGE LN
Practice Address - Street 2:
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003-1632
Practice Address - Country:US
Practice Address - Phone:507-388-5597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered