Yaying Tian, R.D.

Individual provider Active NPI Registered Dietitian · Baldwin, MI

NPI 1174989636 · NPPES record last updated Jan 13, 2016

Key facts

NPI
1174989636
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86062286 (MI)
Practice address
1615 Michigan Ave
Baldwin, MI 49304-7984
Phone
(231) 745-4624
Fax
(231) 745-5031
NPI assigned
Jan 13, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
86062286MIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86062286 MI Yes

Addresses

Primary practice location

1615 Michigan Ave
Baldwin, MI 49304-7984

Mailing address

1615 Michigan Ave
Baldwin, MI 49304-7984
Phone (231) 745-4624

Other providers in Baldwin, MI

All providers in Baldwin, MI · Registered Dietitian in Michigan

Sources for this page

Verify at the official NPI Registry.