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Jody Kay Smith, RD,LD,CDE

Dietitian, Registered in Minneapolis, MN. Individual provider (NPI-1).

NPI number1528242575
StatusActive
Last updated in NPPESFeb 25, 2020

Details

NPI
1528242575
Entity type
Individual (NPI-1)
Name
Mrs. Jody Kay Smith
Credential
RD,LD,CDE
Sex
Female
Sole proprietor
No
Enumeration date
Dec 27, 2007
Certification date
Feb 25, 2020
Last updated
Feb 25, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered1784MNYes
133V00000X Dietitian, RegisteredD-553ID

Practice location

701 Park Ave
Minneapolis, MN 55415-1623

Phone 612-873-6963

Mailing address

701 Park Ave
Minneapolis, MN 55415-1623

Phone 612-873-6963

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