Mary Elizabeth Petrik, R.D. L. D.
Individual provider Active NPI Registered Dietitian · Caldwell, KS
NPI 1922101286 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922101286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 280 (KS)
- Practice address
- 601 S Osage
Caldwell, KS 67022-1654 - Phone
- (620) 845-6492
- Fax
- (620) 845-6475
- NPI assigned
- Sep 5, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 280 | KS | Yes |
Addresses
Primary practice location
601 S Osage
Caldwell, KS 67022-1654
Mailing address
1007 W 160TH St S
Caldwell, KS 67022-8601
Phone (620) 845-2984
Other providers in Caldwell, KS
- Integris Bass Baptist Health Center
- Ali Lee
- Aidan Moreland
- Cooper L Nickel
- Molly Kay Partee
- Harold Andrew Small
- Snezhana Solovey
- Sumner County Hospital District No 1
- Sumner County Hospital District No 1
- Sumner County Hospital District No 1
All providers in Caldwell, KS · Registered Dietitian in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.