Jacquelyn Warner, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

3629 Issued in MN

Practice address

3525 Monterey Dr
St Louis Park, MN 55416-5275

Phone

(952) 993-6200

NPI assigned

Dec 7, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jacquie Donohue Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1023483757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 CLEVELAND AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 MONTEREY DR",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165275",
            "telephone_number": "952-993-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "JACQUELYN",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "3629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUIE",
            "last_name": "DONOHUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yan Wang
• Yuqing Wang
• Vanessa Wankhede Langenfeld, M.D.
• Anna Ward
• Robert Charles Ward, M.D.
• Amal Yusuf Warsame
• Mohamed Mohamoud Warsame
• Najma Warsame
• Nawal Mohamoud Warsame
• Warsame Mohamoud Warsame

• Registered Dietitian in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.