IndividualActive
Mary Bazille, RD
NPI 1700042702 · Nutritionist · Minneapolis, MN
Provider details
- NPI number
- 1700042702
- Entity type
- Individual
- Primary specialty
- NutritionistDietary & Nutritional Service Providers
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- License
- 994556 (VA)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Practice location
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone: (612) 273-4395
Approximate (ZIP-level) locationGet directions
Mailing address
2450 Riverside Ave
Minneapolis, MN 55454-1450
Registry dates
- Enumerated
- 2008-07-30
- Last updated
- 2010-12-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.