Provider Demographics
NPI:1235878836
Name:AHRENS, ANALISA WAAGE (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:ANALISA
Middle Name:WAAGE
Last Name:AHRENS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:MS
Other - First Name:ANALISA
Other - Middle Name:KRISTINA
Other - Last Name:WAAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:8116 MOUNT CURVE BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2356
Mailing Address - Country:US
Mailing Address - Phone:763-772-8779
Mailing Address - Fax:
Practice Address - Street 1:2230 COMO AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1720
Practice Address - Country:US
Practice Address - Phone:651-645-5323
Practice Address - Fax:651-641-6190
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4676133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty