Ellie Lynn Croaker, RD, LD is a
Dietitian, Registered based in Albertville, Minnesota. Ellie Lynn Croaker is licensed to practice in Minnesota (license number ) and her current practice location is
12161 63rd St Ne, Albertville, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(612) 709-3491.
NPI number for Ellie Lynn Croaker is 1063036820 and her current mailing address is 6782 Lakeview Cir # A, Corcoran, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1063036820.
Healthcare Provider's Profile
| Full Name | Ellie Lynn Croaker |
|---|
| Gender | Female |
|---|
| Speciality | Dietitian, Registered |
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| Location | 12161 63rd St Ne, Albertville, Minnesota |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1063036820
- Provider Enumeration Date: 06/07/2020
- Last Update Date: 05/13/2025
Medical Identifiers
Medical identifiers for Ellie Lynn Croaker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1063036820 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 133V00000X | Dietitian, Registered | (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ellie Lynn Croaker is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Ellie Lynn Croaker, RD, LD 6782 Lakeview Cir # A, Corcoran, MN 55340-9798 Ph: (612) 709-3491 | Ellie Lynn Croaker, RD, LD 12161 63rd St Ne, Albertville, MN 55301-4627 Ph: (612) 709-3491 |
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