Healthcare Provider Details

I. General information

NPI: 1982622932
Provider Name (Legal Business Name): JANET S LEVIHN RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PORTER HEALTH SYSTEM 814 LAPORTE AVENUE
VALPARAISO IN
46383
US

IV. Provider business mailing address

1901 CREEKSIDE CT
VALPARAISO IN
46383-0964
US

V. Phone/Fax

Practice location:
  • Phone: 219-263-4739
  • Fax: 219-263-7144
Mailing address:
  • Phone: 219-464-8891
  • Fax: 219-263-7144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: