NPI 1437205127 · live from the CMS NPI Registry
Sandra L Blackwell, R.D.
Dietitian, Registered in Grand Rapids, MI. National Provider Identifier 1437205127, active.
NPI record
| NPI | 1437205127 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 100 Michigan St Ne, Grand Rapids, MI 49503 |
| Practice phone | 616-391-2867 |
| Mailing address | 100 Michigan St Ne, Mc 109 Attn Julie L, Grand Rapids, MI 49503 |
| Enumerated | January 26, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 197637 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.