Doctor Name: | MS. MICHELLE RENAE SMITH |
NPI Number: | 1366593220 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D.,L.D.N |
License Number: | 164.003540 |
Business Practice Address: | 1004 Health Center Dr Ste 212 Mattoon, IL - 619389253 |
Business Phone Number: | 2172582552 |
Business Fax Number: | |
Mailing Address: | 405 Cr 1400e, WINDSOR |
State: | IL |
Postal Code: | 619577014 |
Phone Number: | 2177526604 |
Fax Number: | |
NPI Enumeration Date: | 01/16/2007 |
NPI Last Update Date: | 03/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 164.003540 |
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 |