Samantha Parker, RDN
Individual provider Active NPI Registered Dietitian · Saltillo, MS
NPI 1750826699 · NPPES record last updated Jan 2, 2017
Key facts
- NPI
- 1750826699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- D1730 (MS)
- Practice address
- 122 Willowbrook Dr
Saltillo, MS 38866-6895 - Phone
- (662) 869-3700
- NPI assigned
- Jan 2, 2017
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D1730 | MS | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Care LLC | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D1730 | MS | Yes |
Addresses
Primary practice location
122 Willowbrook Dr
Saltillo, MS 38866-6895
Mailing address
122 Willowbrook Dr
Saltillo, MS 38866-6895
Phone (662) 869-3700
Other providers in Saltillo, MS
- Nutrition Care LLC
- Cooper Long Ogg
- Kimberly Painter
- James R Palmer
- Paige Grant Parker
- Amanda Patterson
- Javous Peavey
- Amanda Lee Perry
- Mary Camille Powell
- James B Raiford Jr.
All providers in Saltillo, MS · Registered Dietitian in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2017. 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.