MEDICARE: MRS. JOANN GINGERICH RDN, CD

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	37002071A	IN

General Provider Information

NPI Number	:	1225459779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOANN GINGERICH RDN, CD

Provider Business Mailing Address
First Line	:	6514 HYDE PARK DR
Second Line	:
City	:	ZIONSVILLE
State	:	IN
Zip	:	46077-8258
Country	:	US
Telephone Number	:	609-865-7204
Fax Number	:

Provider Business Practice Location Address
First Line	:	6514 HYDE PARK DR
Second Line	:
City	:	ZIONSVILLE
State	:	IN
Zip	:	46077-8258
Country	:	US
Telephone Number	:	609-865-7204
Fax Number	:

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

Provider Enumeration Date	:	01/01/2014
Last Update Date	:	01/01/2014

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