Mindy Lee Wallace in Quincy - Dietitian, Registered
Mindy Lee Wallace - NPI 1851305304
Mindy Lee Wallace is a Dietitian, Registered in Quincy, Illinois. Mindy Lee Wallace practices all healthcare services and medical treatments related to Dietitian, Registered. The NPI Number for Mindy Lee Wallace is 1851305304. The last update date is 2008-09-22.
Mindy Lee Wallace's current location address is 2820 E Bluff Ct, Quincy, Illinois. You can contact this provider via phone number 2174406458. The mailing address for Mindy Lee Wallace is 2820 E Bluff Ct, Quincy, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mindy Lee Wallace |
|---|---|
| Address | 2820 E Bluff Ct, Quincy, Illinois |
| Phone Number | 2174406458 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | RD LDN |
NPI Number Detail
| NPI Number | 1851305304 |
|---|---|
| Provider Enumeration Date | 2006-07-28 |
| Last Updated Date | 2008-09-22 |
Provider Mailing Address Detail
| Address | 2820 E Bluff Ct |
|---|---|
| City | Quincy |
| State | Illinois (IL) |
| Post Code | 623051329 |
| Phone Number | 2174406458 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dietitian, Registered |
|---|---|
| Taxonomy | 133V00000X |
| Licence No | 164003636 |
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Definition: A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 132009 | IL | BLUE CROSS BLUE SHIELD IL | |
| 75113 | IL | QUINCY HEALTH CARE MANAGE |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Mindy Lee Wallace by the Centers for Medicare & Medicaid Services?
The Mindy Lee Wallace has been issued the NPI (National Provider Identifier) 1851305304 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Mindy Lee Wallace's facilities are geographically located?
The facilities of Mindy Lee Wallace are physically situated at the following location: 2820 E Bluff Ct, Quincy, IL, 623051329.
What is Mindy Lee Wallace's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Mindy Lee Wallace is Dietitian, Registered, and the taxonomy classification code that categorizes this area of expertise is 133V00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1851305304 to Mindy Lee Wallace?
The Centers for Medicare & Medicaid Services assigned the 1851305304 to Mindy Lee Wallace on 2006-07-28.
As of what date was the information regarding Mindy Lee Wallace, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mindy Lee Wallace, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2008-09-22.