Provider Demographics
NPI:1740973650
Name:METCALFE, LINDSEY (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:METCALFE
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:PETTIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3742 ELMO RD
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55305-4272
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6385 OLD SHADY OAK RD
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3299
Practice Address - Country:US
Practice Address - Phone:612-638-2778
Practice Address - Fax:612-206-8232
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4357133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered