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NPI Code Detail

MEDICARE: MS. JEANNETTE M. BRUNETTI MNT; RD

MEDICARE: MS. JEANNETTE M. BRUNETTI MNT; RD
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
1133V00000XRegistered Dietitian817151MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11265444897OTHERMINPI

General Provider Information

NPI Number : 1275758419
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JEANNETTE M. BRUNETTI MNT; RD
Provider Business Mailing Address
First Line : 225 E 5TH ST
Second Line : SUITE 200
City : FLINT
State : MI
Zip : 48502-1641
Country : US
Telephone Number : 810-249-6547
Fax Number : 810-244-1187
Provider Business Practice Location Address
First Line : 225 E 5TH ST
Second Line : SUITE 200
City : FLINT
State : MI
Zip : 48502-1641
Country : US
Telephone Number : 810-249-6547
Fax Number : 810-244-1187
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2007
Last Update Date : 09/14/2015

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