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General NPI Number Information
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NPI Number | 1942475207
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Entity Type | Individual
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Provider Name | CHEYENNE WORKMAN RD CD
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Gender | Female
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 6145 N 940 W
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City | MIDDLETOWN
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State | IN
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Zip | 47356
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Country | US
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Telephone | 765-620-8400
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Fax | 765-779-4010
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Provider Business Mailing Address
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Address Line | 778 S MORRISTOWN PIKE
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City | GREENFIELD
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State | IN
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Zip | 46140-7885
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Country | US
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Telephone | 765-969-2429
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Fax | 765-779-4010
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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 | 37001827
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License Number State | IN
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