Willie, Marya Dawn

Willie, Marya Dawn is an individual health care provider with primary practice located at 705 Pleasant Ave S Essentia Health Park Rapids Clinic, Park Rapids MN 56470-1440. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Willie, Marya Dawn can be contacted via phone (218) 732-2800.

Contact Information

Primary practice address
705 Pleasant Ave S Essentia Health Park Rapids Clinic Park Rapids MN 56470-1440
Phone: (218) 732-2800
Fax: (218) 732-2857
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 2280 Minnesota

Profile Details

NPI number 1306887393
LBN Legal business name Willie, Marya Dawn
Credentials LRD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Mar 13th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306887393 NPPES
Minnesota Other 34871 LHS/BANNERHEALTH #
Minnesota Other 6300246 LHS/BANNERHEALTH #
Minnesota Other 6300248 LHS/BANNERHEALTH #
Minnesota Other 6300247 LHS/BANNERHEALTH #
Minnesota Other HP39460 LHS/BANNERHEALTH #
Minnesota Other 23627 LHS/BANNERHEALTH #

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