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General NPI Number Information
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NPI Number | 1134287865
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Entity Type | Individual
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Provider Name | KAREN M. CLEVELAND RD, CD
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 600 EAST BLVD NUTRITION SERVICES DEPARTMENT
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City | ELKHART
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State | IN
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Zip | 46514-2483
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Country | US
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Telephone | 574-523-3236
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Fax | 574-296-6504
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Provider Business Mailing Address
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Address Line | PO BOX 4776
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City | SOUTH BEND
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State | IN
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Zip | 46634-4667
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Country | US
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Telephone | 574-523-3148
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Fax | 574-523-3492
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 720478
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License Number State | IN
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