Patricia Ruzicka, RD, LD

Individual provider Active NPI Registered Dietitian · Berkeley, MO

NPI 1174993646 · NPPES record last updated Sep 28, 2015

Key facts

NPI
1174993646
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2014033918 (MO)
Practice address
6121 N Hanley Rd
Berkeley, MO 63134-2003
Phone
(314) 615-0557
NPI assigned
Sep 28, 2015
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)
No

State licenses

LicenseStateTypeSpecialty
2014033918MOMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2014033918 MO Yes

Addresses

Primary practice location

6121 N Hanley Rd
Berkeley, MO 63134-2003

Mailing address

4547 Gibson Ave
Saint Louis, MO 63110-1519

Other providers in Berkeley, MO

All providers in Berkeley, MO · Registered Dietitian in Missouri

Sources for this page

Verify at the official NPI Registry.