NPI 1598094823 · live from the CMS NPI Registry
Avera Queen Of Peace
Dietitian, Registered in Mitchell, SD. National Provider Identifier 1598094823, active.
NPI record
| NPI | 1598094823 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 525 N Foster St, Mitchell, SD 57301 |
| Practice phone | 605-995-2000 |
| Enumerated | December 16, 2009 |
| Last updated | September 14, 2020 |
| Authorized official | Douglas Ekeren, President/Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.