Healthcare Provider Details

I. General information

NPI: 1487722427
Provider Name (Legal Business Name): ELAINE KUZNAR RD LD CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MERCY HOSPITAL 3000 MACK ROAD--DIABETES EDUCATION
FAIRFIELD OH
45014
US

IV. Provider business mailing address

8832 REVERE RUN
WEST CHESTER OH
45069-3628
US

V. Phone/Fax

Practice location:
  • Phone: 513-682-1278
  • Fax:
Mailing address:
  • Phone: 513-779-9552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number133
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: