MEDICARE: ANNA RATHBUN CN

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	133NN1002X	Nutrition Education Nutritionist		CA

General Provider Information

NPI Number	:	1710129598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA RATHBUN CN

Provider Business Mailing Address
First Line	:	6781 ROAD 19
Second Line	:
City	:	LITTLE RIVER
State	:	CA
Zip	:	95456
Country	:	US
Telephone Number	:	707-937-0476
Fax Number	:	707-937-0476

Provider Business Practice Location Address
First Line	:	45015 UKIAH STREET
Second Line	:
City	:	MENDOCINO
State	:	CA
Zip	:	95460
Country	:	US
Telephone Number	:	707-937-0476
Fax Number	:

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

Provider Enumeration Date	:	03/25/2009
Last Update Date	:	03/25/2009

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