Healthcare Provider Details

I. General information

NPI: 1932389749
Provider Name (Legal Business Name): RENAL NUTRITION CONSULTANTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 VILLA LINDE PKWY
FLINT MI
48532-3423
US

IV. Provider business mailing address

PO BOX 439
GRAND BLANC MI
48480-0439
US

V. Phone/Fax

Practice location:
  • Phone: 810-720-0162
  • Fax: 810-720-0301
Mailing address:
  • Phone: 810-923-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number StateMI

VIII. Authorized Official

Name: MRS. MELISSA D PIEPER
Title or Position: RENAL DIETITIAN
Credential: MBA, RD
Phone: 810-923-5600