Ellen Deette Boyer, RD

Individual provider Active NPI Registered Dietitian · Cadillac, MI

NPI 1487215463 · NPPES record last updated Jun 21, 2019

Key facts

NPI
1487215463
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
Practice address
400 Hobart St
Cadillac, MI 49601-2389
Phone
(231) 876-6633
NPI assigned
Jun 21, 2019
Sex
Female
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Yes

Addresses

Primary practice location

400 Hobart St
Cadillac, MI 49601-2389

Mailing address

400 Hobart St
Cadillac, MI 49601-2389
Phone (231) 876-6633

Other providers in Cadillac, MI

All providers in Cadillac, MI · Registered Dietitian in Michigan

Sources for this page

Verify at the official NPI Registry.