Active NPI
Miranda Haugrud, RD LD
- Registered Dietitian
- Wadena, MN
National Provider Identifier
1659778249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3108
- Practice address
- 415 Jefferson St N
Wadena, MN 56482-1264 - Phone
- (218) 632-7112
- NPI assigned
- Nov 25, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 3108 | MN | Primary |
Addresses
Primary practice location
415 Jefferson St N
Wadena, MN 56482-1264
Mailing address
415 Jefferson St N
Wadena, MN 56482-1264
Phone (218) 632-7112
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3108 | MN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487289600000",
"number": "1659778249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 JEFFERSON ST N",
"city": "WADENA",
"state": "MN",
"postal_code": "564821264",
"telephone_number": "218-632-7112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 JEFFERSON ST N",
"city": "WADENA",
"state": "MN",
"postal_code": "564821264",
"telephone_number": "218-632-7112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUGRUD",
"first_name": "MIRANDA",
"credential": "RD LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-11-25",
"last_updated": "2017-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "3108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wadena, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.