Basic Information
| Provider Information | |||||||||
| NPI: | 1467404012 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SPENNINGSBY | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | MICHELLE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PHARMD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 914 S. 8TH ST (S-5) | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123473917 | ||||||||
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| Practice Location | |||||||||
| Address1: | 915 E 1ST ST | ||||||||
| Address2: | |||||||||
| City: | DULUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 558052107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2182495555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 11/01/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | N | Dietary & Nutritional Service Providers | Dietitian, Registered | 1835P1200X | 119679 | MN | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.