Daisy Arsenault, REGISTERED DIETITIAN

Individual provider Active NPI Registered Dietitian · Gallup, NM

NPI 1780123935 · NPPES record last updated Feb 21, 2017

Key facts

NPI
1780123935
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LD-0889 (NM)
Practice address
2111 College Dr
Gallup, NM 87301-5600
Phone
(505) 863-1820
Fax
(505) 863-1898
NPI assigned
Feb 21, 2017
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)
Yes

State licenses

LicenseStateTypeSpecialty
LD-0889NMMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD-0889 NM Yes

Addresses

Primary practice location

2111 College Dr
Gallup, NM 87301-5600

Mailing address

1901 Red Rock Dr
Gallup, NM 87301-5683
Phone (505) 863-1820

Other providers in Gallup, NM

All providers in Gallup, NM · Registered Dietitian in New Mexico

Sources for this page

Verify at the official NPI Registry.