Healthcare Provider Details
I. General information
NPI: 1730535360
Provider Name (Legal Business Name): PRISCILLA PEREZ SCHMID MPH, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/12/2016
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
118 N CONISTOR LN STE B-414
LIBERTY MO
64068-1957
US
IV. Provider business mailing address
6821 N CORRINGTON AVE
KANSAS CITY MO
64119-1618
US
V. Phone/Fax
- Phone: 816-368-1194
- Fax:
- Phone: 816-368-1194
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1201X |
| Taxonomy | Obesity and Weight Management Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | 86043300 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: