MEDICARE: GINA SELLINGER MPH, RDN

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	133N00000X	Nutritionist
2	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1356976690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA SELLINGER MPH, RDN

Provider Business Mailing Address
First Line	:	PO BOX 332
Second Line	:
City	:	MAPLE CITY
State	:	MI
Zip	:	49664-0332
Country	:	US
Telephone Number	:	734-716-9771
Fax Number	:

Provider Business Practice Location Address
First Line	:	3130 W CHENEY RD
Second Line	:
City	:	MAPLE CITY
State	:	MI
Zip	:	49664-8758
Country	:	US
Telephone Number	:	734-716-9771
Fax Number	:

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

Provider Enumeration Date	:	03/06/2020
Last Update Date	:	06/07/2024

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