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General NPI Number Information
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NPI Number | 1437495850
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Entity Type | Individual
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Provider Name | JANA LYNN FUEHRING RD
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Gender | Female
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Dates
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Enumeration Date | 12/13/2012
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Last Update Date | 12/13/2012
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Provider Practice Location Address
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Address Line | 105 E HOSPITAL DR
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City | SWEET SPRINGS
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State | MO
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Zip | 65351-2229
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Country | US
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Telephone | 660-335-7416
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 S BISMARK ST PO BOX 853
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City | CONCORDIA
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State | MO
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Zip | 64020-9366
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Country | US
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Telephone | 816-838-0531
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Fax |
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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 | 2005032828
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License Number State | MO
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