Hannah Gabrielle Bercot
Dietitian, Registered in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1164062774
StatusActive
Last updated in NPPESMay 7, 2021
Details
- NPI
- 1164062774
- Entity type
- Individual (NPI-1)
- Name
- Hannah Gabrielle Bercot
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 11, 2020
- Certification date
- May 7, 2021
- Last updated
- May 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 37003033A | IN | Yes |
Practice location
11108 Parkview Circle DrFort Wayne, IN 46845-1730
Phone 260-266-5700 · Fax 260-266-5910
Mailing address
11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
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