Active NPI
Liesbeth Glenna Fernandez, RD
- Registered Dietitian
- Flint, MI
National Provider Identifier
1568700698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 4466 W Bristol Rd
Flint, MI 48507-3170 - Phone
- (810) 908-5433
- Fax
- (810) 733-7001
- NPI assigned
- Jan 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
4466 W Bristol Rd
Flint, MI 48507-3170
Mailing address
4466 W Bristol Rd
Flint, MI 48507-3170
Phone (810) 908-5433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358985600000",
"number": "1568700698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4466 W BRISTOL RD",
"city": "FLINT",
"state": "MI",
"postal_code": "485073170",
"telephone_number": "810-908-5433",
"fax_number": "810-733-7001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4466 W BRISTOL RD",
"city": "FLINT",
"state": "MI",
"postal_code": "485073170",
"telephone_number": "810-908-5433",
"fax_number": "810-733-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "LIESBETH",
"middle_name": "GLENNA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-24",
"last_updated": "2013-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.