NPI 1861741241 · live from the CMS NPI Registry
Amy Dawn Ellis, MS, RD, LDN
Dietitian, Registered in Alamo, NM. National Provider Identifier 1861741241, active.
NPI record
| NPI | 1861741241 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | Highway 169 Mile Marker 29, Alamo, NM 87825 |
| Practice phone | 575-854-2642 |
| Mailing address | Po Box 5907, Highway 169 Mile Marker 29, Alamo, NM 87825 |
| Enumerated | August 31, 2012 |
| Last updated | August 31, 2012 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | LD-0750 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.