Doctor Name: | MRS. AUDREY LYNN PETERS |
NPI Number: | 1861764060 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | 1042112 |
Business Practice Address: | 5230 E Stop 11 Rd Building A, Suite 190 Indianapolis, IN - 462376398 |
Business Phone Number: | 3178513695 |
Business Fax Number: | |
Mailing Address: | 5230 E Stop 11 Rd, Building A, Suite 190 INDIANAPOLIS |
State: | IN |
Postal Code: | 462376398 |
Phone Number: | 3178513695 |
Fax Number: | |
NPI Enumeration Date: | 02/02/2012 |
NPI Last Update Date: | 02/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 1042112 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |