Doctor Name: | AMY PUCKETT |
NPI Number: | 1962829317 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | 86009206 |
Business Practice Address: | 5750 W Thunderbird Rd Ste G790 Glendale, AZ - 853064678 |
Business Phone Number: | 6028437171 |
Business Fax Number: | 6028435909 |
Mailing Address: | 3003 N Central Ave, Suite 400 PHOENIX |
State: | AZ |
Postal Code: | 850122902 |
Phone Number: | 6023513015 |
Fax Number: | 6022243315 |
NPI Enumeration Date: | 03/24/2014 |
NPI Last Update Date: | 03/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 86009206 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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 |