NPI 1891552550 · live from the CMS NPI Registry
Tracy Boggs, RDN
Dietitian, Registered in Central Lake, MI. National Provider Identifier 1891552550, active.
NPI record
| NPI | 1891552550 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 3604 Childs Ln, Central Lake, MI 49622 |
| Practice phone | 231-676-8553 |
| Enumerated | February 29, 2024 |
| Last updated | February 29, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 726131 |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.