Tracy Marie Booth in Grand Rapids - Nutrition, Pediatric
Tracy Marie Booth - NPI 1124094321
Tracy Marie Booth is a Nutrition, Pediatric in Grand Rapids, Michigan. Tracy Marie Booth practices all healthcare services and medical treatments related to Nutrition, Pediatric. The NPI Number for Tracy Marie Booth is 1124094321. The last update date is 2007-07-08.
Tracy Marie Booth's current location address is 1550 Giddings Se, Grand Rapids, Michigan. You can contact this provider via phone number 6165747617 and fax number 6165747617. The mailing address for Tracy Marie Booth is 1550 Giddings Se, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tracy Marie Booth |
|---|---|
| Address | 1550 Giddings Se, Grand Rapids, Michigan |
| Phone Number | 6165747617 |
| Fax Number | 6165747617 |
| Sole Proprietor | X |
| Credentials | R.D. |
NPI Number Detail
| NPI Number | 1124094321 |
|---|---|
| Provider Enumeration Date | 2006-02-27 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1550 Giddings Se |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 49507 |
| Phone Number | 6165747617 |
| Fax Number | 6165747617 |
Provider's Primary Taxonomy Detail
| Speciality | Nutrition, Pediatric |
|---|---|
| Taxonomy | 133Vn1004X |
| Licence No | 723477 |
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Definition: An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn |
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Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Tracy Marie Booth by the Centers for Medicare & Medicaid Services?
The Tracy Marie Booth has been issued the NPI (National Provider Identifier) 1124094321 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Tracy Marie Booth's facilities are situated?
The facilities of Tracy Marie Booth are physically located at the following address: 1550 Giddings Se, Grand Rapids, MI, 49507.
What is Tracy Marie Booth's area of expertise and its corresponding taxonomy classification?
The Tracy Marie Booth's field of specialization is Nutrition, Pediatric, and it falls under the taxonomy code 133Vn1004X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1124094321 to Tracy Marie Booth?
The Centers for Medicare & Medicaid Services originally issued the 1124094321 to Tracy Marie Booth on 2006-02-27.
As of what date was the information regarding Tracy Marie Booth, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Tracy Marie Booth, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.