Grace Cidlik, MS, RD, LD
Individual provider Active NPI Registered Dietitian · Bolivar, MO
NPI 1225259062 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1225259062
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2006005847 (MO)
- Practice address
- 1500 N. Oakland
Bolivar, MO 65613-3011 - Phone
- (417) 326-6000
- NPI assigned
- May 1, 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 |
|---|---|---|---|
| 2006005847 | MO | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2006005847 | MO | Yes |
Addresses
Primary practice location
1500 N. Oakland
Bolivar, MO 65613-3011
Mailing address
1500 N. Oakland
Bolivar, MO 65613-3011
Phone (417) 326-6000
Other providers in Bolivar, MO
- Cara Lea Carrington
- Casablanca Care Center, LLC
- Central Care PA
- Central Care, PA
- Chiropractic Health and Wellness Center LLC
- Citizens Memorial Health Care Foundation
- Citizens Memorial Health Care Foundation
- Citizens Memorial Health Care Foundation
- Citizens Memorial Health Care Foundation
- Citizens Memorial Health Care Foundation
All providers in Bolivar, MO · Registered Dietitian in Missouri
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.