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NPI Code Detail

MEDICARE: JANELLE COUTURE RDN, CD

MEDICARE:   JANELLE  COUTURE  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
1133V00000XRegistered Dietitian1103410IN

General Provider Information

NPI Number : 1851775720
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANELLE COUTURE RDN, CD
Provider Business Mailing Address
First Line : 3015 WHITEGATE DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-2440
Country : US
Telephone Number : 260-341-9440
Fax Number :
Provider Business Practice Location Address
First Line : 2927 LAKE AVE
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-5415
Country : US
Telephone Number : 260-745-1200
Fax Number : 260-745-5968
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2015
Last Update Date : 08/07/2015

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Directions to “ JANELLE COUTURE RDN, CD” Practice Location

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