NPI 1407616949 · live from the CMS NPI Registry
Fallon Bader, MS, RDN, LD
Dietitian, Registered in Jemez Pueblo, NM. National Provider Identifier 1407616949, active.
NPI record
| NPI | 1407616949 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 139 Bear Head Canyon Rd Unit B, Jemez Pueblo, NM 87024 |
| Practice phone | 908-670-2348 |
| Mailing address | 31 Cedar Hill Pl Ne, Albuquerque, NM 87122 |
| Enumerated | March 21, 2024 |
| Last updated | March 21, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | NDP-2024-0036 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.