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NPI Code Detail

MEDICARE: REBEKAH DEWITT RDN

MEDICARE:   REBEKAH  DEWITT  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
1133V00000XRegistered Dietitian86050943AL

General Provider Information

NPI Number : 1811361520
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBEKAH DEWITT RDN
Provider Business Mailing Address
First Line : 1900 GAULT AVE N
Second Line :
City : FORT PAYNE
State : AL
Zip : 35967-3418
Country : US
Telephone Number : 256-997-9200
Fax Number :
Provider Business Practice Location Address
First Line : 1900 GAULT AVE N
Second Line :
City : FORT PAYNE
State : AL
Zip : 35967-3418
Country : US
Telephone Number : 256-997-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2015
Last Update Date : 11/18/2015

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Directions to “ REBEKAH DEWITT RDN” Practice Location

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