Healthcare Provider Details

I. General information

NPI: 1336661982
Provider Name (Legal Business Name): DANIELLE MEYERS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CHOME NODAKE
GINOWAN-SHI OKINAWA-KEN
9012203
JP

IV. Provider business mailing address

PSC 482 BOX 1600
FPO AP
96362-9998
US

V. Phone/Fax

Practice location:
  • Phone: 98-971-7555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: