Marita Watrin Haberman
Individual provider Active NPI Registered Dietitian · Sandstone, MN
NPI 1740340736 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1740340736
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1442 (MN)
- Practice address
- 109 Court Ave S
Sandstone, MN 55072-5120 - Phone
- (320) 245-2211
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1442 | MN | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1442 | MN | Yes |
Addresses
Primary practice location
109 Court Ave S
Sandstone, MN 55072-5120
Mailing address
109 Court Ave S
Sandstone, MN 55072-5120
Phone (320) 245-2211
Other providers in Sandstone, MN
- Kimberly June Fletcher
- Foster Transportation Services LLC
- James Richard Franzel
- Peggy Ann Frisch
- Gateway Family Health Clinic, LTD.
- Andrea Jean Hanson
- Daniel Quade Hanson
- Ryan Mark Harden
- Jeffrey John Haskamp
- Julie Lynn Haverkamp
All providers in Sandstone, MN · Registered Dietitian in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.