Provider Demographics
NPI:1588335566
Name:LIBBI HOEL NUTRITION LLC
Entity type:Organization
Organization Name:LIBBI HOEL NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:BLUMER
Authorized Official - Last Name:HOEL
Authorized Official - Suffix:
Authorized Official - Credentials:RD RN
Authorized Official - Phone:651-491-3490
Mailing Address - Street 1:4667 PARKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-2130
Mailing Address - Country:US
Mailing Address - Phone:651-491-3490
Mailing Address - Fax:
Practice Address - Street 1:4667 PARKRIDGE DR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-2130
Practice Address - Country:US
Practice Address - Phone:651-491-3490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty