Basic Information
Provider Information
NPI: 1841620887
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REED
FirstName: MICHELLE
MiddleName: L.
NamePrefix: MS.
NameSuffix:  
Credential: RD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 191
Address2:  
City: ROCKLAND
State: DE
PostalCode: 197230191
CountryCode: US
TelephoneNumber: 3026514000
FaxNumber: 3026514945
Practice Location
Address1: 1600 ROCKLAND RD
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198033607
CountryCode: US
TelephoneNumber: 3026514200
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/12/2013
LastUpdateDate: 01/02/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000XDN-0000503DEN Dietary & Nutritional Service ProvidersDietitian, Registered 
133V00000XDN0000503DEY Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


Home