Crystal Bouchard, RD
Individual provider Active NPI Registered Dietitian · Magnolia, DE
NPI 1366792111 · NPPES record last updated Sep 19, 2012
Key facts
- NPI
- 1366792111
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 142 Trillium Dr
Magnolia, DE 19962-9476 - Phone
- (302) 359-6106
- NPI assigned
- Sep 19, 2012
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DE | Yes |
Addresses
Primary practice location
142 Trillium Dr
Magnolia, DE 19962-9476
Mailing address
142 Trillium Dr
Magnolia, DE 19962-9476
Other providers in Magnolia, DE
- Tiffany Nicole Barnes
- Bayside Medical LLC
- Frankie Bobbie Bell
- Christopher Charles Betz
- Jill Lynn Bosak
- Laila Brooks-Collins
- Charles Brooks Jr.
- Scott M Butler
- Counseling Services, LLC
- Jamie Cummings
All providers in Magnolia, DE · Registered Dietitian in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2012. 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.