Provider Demographics
NPI:1528318854
Name:OSWALD, ASHLEY (RDN, IFNCP, CNSC, LD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:OSWALD
Suffix:
Gender:F
Credentials:RDN, IFNCP, CNSC, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5123 W 98TH ST # 1206
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55437-2040
Mailing Address - Country:US
Mailing Address - Phone:612-805-7142
Mailing Address - Fax:
Practice Address - Street 1:5123 W 98TH ST # 1206
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55437-2040
Practice Address - Country:US
Practice Address - Phone:612-805-7142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
MN3149133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered