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Contact Information

ANGELA M TULLBANE, RD, LD
16800 37TH PL N
STE 100
PLYMOUTH, MN55446
 Phone: 763-520-7870
 Fax: 763-520-7580
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for ANGELA M TULLBANE · (Female)

NPI # 1689211526
Status Active
Credentials RD, LD
Entity Individual
Enumeration date 12/10/2019
Last updated 11/09/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 4035
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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