Provider Demographics
NPI:1932721610
Name:MCPHERSON, DEIRDRE NICOLE (RDN, LDN, CDCES)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:NICOLE
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:RDN, LDN, CDCES
Other - Prefix:
Other - First Name:DEIRDRE
Other - Middle Name:NICOLE
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LDN, CDCES
Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11475 ROBINSON DR NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-3746
Practice Address - Country:US
Practice Address - Phone:763-587-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-15
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3465133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3465OtherLICENSED DIETITIAN/LICENSED DIETITIAN NUTRITIONIST
32100651OtherCERTIFIED DIABETES CARE AND EDUCATION SPECIALIST
1092827OtherREGISTERED DIETITIAN/REGISTERED DIETITIAN NUTRITIONIST