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General NPI Number Information
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NPI Number | 1760620512
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Entity Type | Individual
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Provider Name | LISA DAWN BERNS R.D., C.D.
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Gender | Female
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 13402 W 160 N
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City | LINTON
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State | IN
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Zip | 47441-6572
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Country | US
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Telephone | 812-847-9293
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Fax |
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Provider Business Mailing Address
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Address Line | RR 4 BOX 396
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City | LINTON
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State | IN
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Zip | 47441-9345
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Country | US
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Telephone | 812-847-9293
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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 | 807772
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License Number State | IN
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