Provider Demographics
NPI:1194970038
Name:FUCHS, JANELLE
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:FUCHS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 36TH AVE S SUITE #1
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406
Mailing Address - Country:US
Mailing Address - Phone:612-460-8559
Mailing Address - Fax:888-965-8966
Practice Address - Street 1:2805 CAMPUS DR STE 115
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2677
Practice Address - Country:US
Practice Address - Phone:763-577-7800
Practice Address - Fax:763-577-7855
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2782133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered