Alice Lee
Individual provider Active NPI Registered Dietitian · Water Valley, MS
NPI 1487040663 · NPPES record last updated Apr 14, 2015
Key facts
- NPI
- 1487040663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1001126 (MS)
- Practice address
- 604 S Main St
Water Valley, MS 38965-3468 - Phone
- (662) 473-4050
- Fax
- (662) 473-4191
- NPI assigned
- Apr 14, 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001126 | MS | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1001126 | MS | Yes |
Addresses
Primary practice location
604 S Main St
Water Valley, MS 38965-3468
Mailing address
604 S Main St
Water Valley, MS 38965-3468
Phone (662) 473-4050
Other providers in Water Valley, MS
- John F Kimball
- Grady Madison Kuykendall
- Myranda Lancaster
- Anna Mathis Larson
- Lee Pullen
- Joeli Link
- Lee Brian Lott
- Brenda McCullough
- Carrie Aden McDaniel
- Jennifer S McGavock
All providers in Water Valley, MS · Registered Dietitian in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2015. 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.