ABBY JO TIBODEAU (NPI# 1912471665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912471665 |
| Entity Type | Individual |
| Full Name | ABBY JO TIBODEAU |
| Credential | RD, LD |
| Practice Address |
1230 E Main St Mankato MN 56001-5066 |
| Mailing Address |
120 Mallard Ct Mankato MN 56001-1860 |
| Practice Telephone | 5076251811 |
| Mailing Telephone | 5073277993 |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2020-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 3033 | MN | Dietary & Nutritional Service Providers |
| Street Address |
1230 E MAIN ST |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-5066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154325173 | Kimberly A Aho | Psychiatry & Neurology | 1230 E Main St, Mankato, MN 56001-5066 | 2005-06-08 |
| 1699381418 | Emily Anna Potter | Nurse Practitioner | 1230 E Main St, Mankato, MN 56001-5066 | 2020-09-17 |
| 1699233965 | Zachary Joel Stevens | Physician Assistant | 1230 E Main St, Mankato, MN 56001-5066 | 2019-03-06 |
| 1033674288 | Season Marie Hoffman | Nurse Practitioner | 1230 E Main St, Mankato, MN 56001-8001 | 2019-02-01 |
| 1154800886 | Travis Mattson | Physical Therapist | 1230 E Main St, Mankato, MN 56001-8001 | 2018-08-13 |
| 1801383955 | Nathan Evers | Pharmacist | 1230 E Main St, Mankato, MN 56001-5066 | 2018-04-15 |
| 1942704945 | Jennifer Sue Marble | Registered Nurse | 1230 E Main St, Mankato, MN 56001 | 2018-03-23 |
| 1669976742 | Brooke Renee Long | Registered Nurse | 1230 E Main St, Mankato, MN 56001 | 2018-03-22 |
| 1245740463 | Galen Mary Hilgendorf | Physician Assistant | 1230 E Main St, Mankato, MN 56001-5066 | 2017-10-02 |
| 1073054995 | Jacob Nienow | Physical Therapist | 1230 E Main St, Mankato, MN 56001-5066 | 2017-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295138469 | Britni Vincent | Dietitian, Registered | 58192 191st Ln, Mankato, MN 56001-7892 | 2014-10-02 |
| 1659883411 | Jessica Lynn Weisbrich | Dietitian, Registered | 1025 Marsh St, Mankato, MN 56001-4752 | 2017-11-01 |
| 1477080851 | Evora Rochelle Sinclair Liddell | Dietitian, Registered | 309 Holly Ln, Mankato, MN 56001-5422 | 2017-05-17 |
| 1760847396 | Kelly Tasky | Dietitian, Registered | 1025 Marsh St, Mankato, MN 56001-4752 | 2015-12-26 |
| 1659770147 | Erin Braun | Dietitian, Registered | 1230 E Main St, Mankato, MN 56001-5066 | 2014-08-20 |
| 1891136446 | Nicole Christine Streich | Dietitian, Registered | 1025 Marsh St, Mankato, MN 56001 | 2013-07-11 |
| 1265704001 | Roxanna Lynne Padilla | Dietitian, Registered | 1025 Marsh St, Mankato, MN 56001-4752 | 2012-02-08 |
| 1891096491 | Grace A Fjeldberg | Dietitian, Registered | 1025 Marsh St, Mankato, MN 56001-4752 | 2010-11-12 |
| 1861647372 | April Lynn Graff | Dietitian, Registered | 2010 Adams St, Mankato, MN 56001-6817 | 2008-11-25 |
| 1407027576 | Amelia Marie Mcquery | Dietitian, Registered | 1025 Marsh St, Mankato, MN 56001-4752 | 2008-03-17 |
| Find all providers in MANKATO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.