Karen E. From, RDN

Individual provider Active NPI Registered Dietitian · Maryville, MO

NPI 1679339162 · NPPES record last updated Feb 26, 2024

Key facts

NPI
1679339162
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2014006998 (MO)
Practice address
33928 Ideal Rd
Maryville, MO 64468-7501
Phone
(660) 528-0731
NPI assigned
Feb 22, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2014006998MOMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2014006998 MO Yes

Addresses

Primary practice location

33928 Ideal Rd
Maryville, MO 64468-7501

Mailing address

33928 Ideal Rd
Maryville, MO 64468-7501
Phone (660) 528-0731

Other providers in Maryville, MO

All providers in Maryville, MO · Registered Dietitian in Missouri

Sources for this page

Verify at the official NPI Registry.