Traci Ann Ray, MS RD
Individual provider Active NPI Registered Dietitian · Sullivan, IN
NPI 1104045871 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104045871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 864188 (IN)
- Practice address
- 2200 N Section St
Sullivan, IN 47882-7523 - Phone
- (812) 268-4311
- Fax
- (812) 268-2648
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 864188 | IN | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 864188 | IN | Yes |
Addresses
Primary practice location
2200 N Section St
Sullivan, IN 47882-7523
Mailing address
11388 Lake Rd
Terre Haute, IN 47802-8437
Phone (812) 894-2205
Other providers in Sullivan, IN
- Virginia (Ginny) Darlene Phegley
- Ashlee Nichole Pinkston
- Josey Pirtle
- Kathleen Pirtle
- R. Vedala and Associates, LLC
- Keshava G Reddy
- Reflective Perspectives Counseling, LLC
- Kaylee May Retseck
- Angela D Rogers
- Rural Community Schools, Inc.
All providers in Sullivan, IN · Registered Dietitian in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.