Provider Demographics
NPI:1396811816
Name:MUNSON, LYNN KRISTIN (RD, LD)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:KRISTIN
Last Name:MUNSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 BELMONT LN E
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2203
Mailing Address - Country:US
Mailing Address - Phone:651-772-0535
Mailing Address - Fax:
Practice Address - Street 1:738 BELMONT LN E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55117-2203
Practice Address - Country:US
Practice Address - Phone:651-772-0535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1475133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered