MEDICARE: KATIE LEWINSKI RD, CDCES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1093299620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE LEWINSKI RD, CDCES

Provider Business Mailing Address
First Line	:	3875 BAY RD STE 2S
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-2423
Country	:	US
Telephone Number	:	989-583-5340
Fax Number	:	989-583-1747

Provider Business Practice Location Address
First Line	:	3875 BAY RD STE 2S
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-2423
Country	:	US
Telephone Number	:	989-583-5340
Fax Number	:	989-583-1747

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2018
Last Update Date	:	07/02/2020

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Directions to “ KATIE LEWINSKI RD, CDCES” Practice Location

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