| Doctor Name: | KELLY LYNN FUGOK |
| NPI Number: | 1851643100 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD |
| License Number: | DN002918 |
| Business Practice Address: | Geisinger Medical Ctr 100 North Academy Avenue, Mc 15-09 Danville, PA - 178220001 |
| Business Phone Number: | 5702143223 |
| Business Fax Number: | 5702717805 |
| Mailing Address: | Geisinger Medical Ctr, 100 North Academy Avenue, Mc 15-09 DANVILLE |
| State: | PA |
| Postal Code: | 178220001 |
| Phone Number: | 5702143223 |
| Fax Number: | 5702717805 |
| NPI Enumeration Date: | 10/11/2012 |
| NPI Last Update Date: | 10/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | DN002918 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| 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 |