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NPI Code Detail

MEDICARE: MRS. EMILY DICKENS MCGLONE MS, RD, LD

MEDICARE: MRS. EMILY DICKENS MCGLONE MS, RD, LD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian166670KY

General Provider Information

NPI Number : 1376094169
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMILY DICKENS MCGLONE MS, RD, LD
Provider Business Mailing Address
First Line : 90 SOUTHPORT DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-1819
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 90 SOUTHPORT DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-1819
Country : US
Telephone Number : 859-494-2561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2016
Last Update Date : 06/12/2020

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