NPI 1205761152 · live from the CMS NPI Registry
Jeannie Clark Burt, RD
Dietitian, Registered in Dadeville, AL. National Provider Identifier 1205761152, active.
NPI record
| NPI | 1205761152 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 263 Redbud Ln, Dadeville, AL 36853 |
| Practice phone | 334-321-1907 |
| Enumerated | June 15, 2026 |
| Last updated | June 15, 2026 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 1062 (AL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.