Doctor Name: | DENISE BLOEMER |
NPI Number: | 1184045130 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | 164005922 |
Business Practice Address: | 1000 Health Center Dr Mattoon, IL - 619389253 |
Business Phone Number: | 2172582199 |
Business Fax Number: | 2172582139 |
Mailing Address: | 1000 Health Center Dr, MATTOON |
State: | IL |
Postal Code: | 619389253 |
Phone Number: | 2172582199 |
Fax Number: | |
NPI Enumeration Date: | 12/18/2013 |
NPI Last Update Date: | 10/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 164005922 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |