NPI 1063989762 · live from the CMS NPI Registry
Mindy Donovan, RDN, LN
Dietitian, Registered in Chamberlain, SD. National Provider Identifier 1063989762, active.
NPI record
| NPI | 1063989762 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 300 S Byron Blvd, Chamberlain, SD 57325 |
| Practice phone | 605-234-7106 |
| Mailing address | 119 S Allcott St, Chamberlain, SD 57325 |
| Enumerated | October 31, 2018 |
| Last updated | October 31, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 0212 (SD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.