Healthcare Provider Details
I. General information
NPI: 1992730147
Provider Name (Legal Business Name): JANET I PERSON RDLMNT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
723 WEST FAIRVIEW
ALBION NE
68620
US
IV. Provider business mailing address
PO BOX 151
ALBION NE
68620-0151
US
V. Phone/Fax
- Phone: 402-395-2191
- Fax: 402-395-5165
- Phone: 402-395-3213
- Fax: 402-395-3173
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | 128 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: