Penny Jean Atkinson, R.D., C.D.E
Individual provider Active NPI Registered Dietitian · Fort Wayne, IN
NPI 1487948733 · NPPES record last updated Jun 3, 2011
Key facts
- NPI
- 1487948733
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 37001912A (IN)
- Practice address
- 4930 Illinois Rd
Fort Wayne, IN 46804-5105 - Phone
- (260) 341-2923
- NPI assigned
- Jun 3, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Kidney Clinics LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 37001912A | IN | Yes |
Addresses
Primary practice location
4930 Illinois Rd
Fort Wayne, IN 46804-5105
Mailing address
14610 Waterbrook Rd
Fort Wayne, IN 46814-9142
Other providers in Fort Wayne, IN
- Athletico LTD
- Audretta Deanne Atkins
- Robin Atkins
- Tyler Atkins
- Harold D Atkinson
- Atlas Chiropractic of Fort Wayne LLC
- Atlas Therapy Collective
- Seetharamaiah Atluri
- Vijaya L Atluri
- Jackson Wyatt Atrops
All providers in Fort Wayne, IN · Registered Dietitian in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2011. 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.