| Doctor Name: | JOAN PIETRON CARLISLE |
| NPI Number: | 1629221395 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LRD |
| License Number: | 111 |
| Business Practice Address: | 2121 Elm Street North Fargo Va Medical Center Fargo, ND - 58102 |
| Business Phone Number: | 7012393700 |
| Business Fax Number: | |
| Mailing Address: | 2721 32nd St S, FARGO |
| State: | ND |
| Postal Code: | 581037868 |
| Phone Number: | 7012321572 |
| Fax Number: | |
| NPI Enumeration Date: | 10/28/2008 |
| NPI Last Update Date: | 10/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 111 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| 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 |