Healthcare Provider Details

I. General information

NPI: 1538636006
Provider Name (Legal Business Name): MUDITA ARORA MSC, MS, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2018
Last Update Date: 11/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 ELLERSLIE PARK BLVD
LEXINGTON KY
40515-5715
US

IV. Provider business mailing address

197 ELLERSLIE PARK BLVD
LEXINGTON KY
40515-5715
US

V. Phone/Fax

Practice location:
  • Phone: 859-457-0115
  • Fax:
Mailing address:
  • Phone: 859-457-0115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition, Education
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyDietitian, Registered
License Number123788
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyNutrition, Renal
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyNutrition, Metabolic
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: