NPI 1811518103 · live from the CMS NPI Registry
Blue Tree Nutrition
Dietitian, Registered in Zionsville, IN. National Provider Identifier 1811518103, active.
NPI record
| NPI | 1811518103 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 75 E Pine St, Zionsville, IN 46077 |
| Practice phone | 410-963-4782 |
| Mailing address | Po Box 73, Carmel, IN 46082 |
| Enumerated | April 28, 2020 |
| Last updated | April 28, 2020 |
| Authorized official | Valerie Polley, Registered Dietitian |
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.