NPI 1750445219 · live from the CMS NPI Registry
Rebecca Ann Blackburn, RD
Dietitian, Registered in Kokomo, IN. National Provider Identifier 1750445219, active.
NPI record
| NPI | 1750445219 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 3500 S Lafountain St, Kokomo, IN 46902 |
| Practice phone | 765-453-8352 |
| Mailing address | 3500 S Lafountain St, P.O. Box 9011, Kokomo, IN 46902 |
| Enumerated | December 20, 2006 |
| Last updated | July 9, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 37001345A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.