Individual provider · NPI-1

Denise Bloemer, RD

Dietitian, Registered · Mattoon, IL

NPI number1184045130
StatusActive
Last updated in NPPESOct 23, 2015

Details

NPI
1184045130
Entity type
Individual (NPI-1)
Name
Denise Bloemer
Credential
RD
Sex
Female
Sole proprietor
No
Enumeration date
Dec 18, 2013
Last updated
Oct 23, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered164005922ILYes

Practice location

1000 Health Center Dr
Mattoon, IL 61938-9253

Phone 217-258-2199 · Fax 217-258-2139

Mailing address

1000 Health Center Dr
Mattoon, IL 61938-9253

Phone 217-258-2199

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