NPI 1508179920 · live from the CMS NPI Registry
Tracy M Blakeman, M.S., R.D.
Dietitian, Registered in Middleville, MI. National Provider Identifier 1508179920, active.
NPI record
| NPI | 1508179920 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2727 Valley Ridge Dr, Middleville, MI 49333 |
| Practice phone | 616-633-3549 |
| Enumerated | July 15, 2010 |
| Last updated | July 15, 2010 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 721639 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.