Active NPI
Wanda Duellman
- Registered Dietitian
- Rochester, MN
National Provider Identifier
1871962936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2967
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 538-0699
- NPI assigned
- Sep 18, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 2967 | MN | Primary |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
3245 310TH St
Cannon Falls, MN 55009-7027
Phone (507) 250-2572
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 |
|---|---|---|---|
| 2967 | MN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442534400000",
"number": "1871962936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3245 310TH ST",
"city": "CANNON FALLS",
"state": "MN",
"postal_code": "550097027",
"telephone_number": "507-250-2572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-538-0699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUELLMAN",
"first_name": "WANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-18",
"last_updated": "2015-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "2967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.