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NPI Code Detail

MEDICARE: EMILY PETERSON MS, RD, CNSC

MEDICARE: EMILY PETERSON MS, RD, CNSC
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 DietitianLD.11290OH

General Provider Information

NPI Number : 1710841424
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY PETERSON MS, RD, CNSC
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2200
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 02/12/2026

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