NPI 1205087111 · live from the CMS NPI Registry
Kristen Ballou, R.D.
Dietitian, Registered in Muskegon, MI. National Provider Identifier 1205087111, active.
NPI record
| NPI | 1205087111 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1500 E Sherman Blvd, Muskegon, MI 49444 |
| Practice phone | 231-672-4682 |
| Enumerated | October 9, 2008 |
| Last updated | October 9, 2008 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 964250 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.