NPI 1114533239 · live from the CMS NPI Registry
Mattie Firlit
Dietitian, Registered in Albuquerque, NM. National Provider Identifier 1114533239, active.
NPI record
| NPI | 1114533239 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102 |
| Practice phone | 505-727-8000 |
| Mailing address | 5320 San Mateo Blvd Ne Apt C29, Albuquerque, NM 87109 |
| Enumerated | September 23, 2020 |
| Last updated | September 23, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 1392 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.