NPI 1194475434 · live from the CMS NPI Registry
Justine Bender
Dietitian, Registered in Goshen, IN. National Provider Identifier 1194475434, active.
NPI record
| NPI | 1194475434 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 200 High Park Ave, Goshen, IN 46526 |
| Practice phone | 574-364-2679 |
| Mailing address | 1722 College Manor Dr, Goshen, IN 46526 |
| Enumerated | March 28, 2022 |
| Last updated | March 28, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nutritionist | 133N00000X | 37003452A (IN) |
| Dietitian, Registered primary | 133V00000X | 37003452A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.