Elizabeth Jean Penn-Wuorinen, CDM, CFPP
Individual provider Active NPI Nutritionist · Fruitland, MD
NPI 1508577180 · NPPES record last updated Dec 5, 2022
Key facts
- NPI
- 1508577180
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutritionist 133N00000X
- Practice address
- 420 Creekside TRL
Fruitland, MD 21826-1950 - Phone
- (443) 201-4589
- NPI assigned
- Dec 5, 2022
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dietary Manager | 132700000X | |||
| Nutritionist | 133N00000X | Yes |
Addresses
Primary practice location
420 Creekside TRL
Fruitland, MD 21826-1950
Mailing address
420 Creekside TRL
Fruitland, MD 21826-1950
Phone (443) 201-4589
Other providers in Fruitland, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2022. 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.