Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIA M KOCKA, CDE
ActiveNutrition, Education · PARK RAPIDS, MN
Registration Details
- NPI Number
- 1710217179
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 7, 2010 (16.326125014419 yrs)
- Last Updated
- Aug 8, 2012
- License
-
R33968 (MN)
Practice Information
- Address
-
705 PLEASANT AVE SPARK RAPIDS, MN, 564701440Browse MN providers · Browse ZIP 56470
- Phone
- 2187322800
- Fax
- 2187322857
- Primary Specialty
-
Nutrition, Education
133NN1002X
Other Nutrition, Education Providers in PARK RAPIDS, MN
| Name | Credential | NPI |
|---|---|---|
| GENEVIEVE A KERANEN | CDE | 1033156997 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.