Provider Demographics
NPI:1982463741
Name:COGGINS, ANNA J (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:J
Last Name:COGGINS
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1359
Mailing Address - Country:US
Mailing Address - Phone:336-906-4390
Mailing Address - Fax:
Practice Address - Street 1:3250 W 66TH ST APT 548
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5514
Practice Address - Country:US
Practice Address - Phone:651-447-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006838133V00000X
MN5223133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered