Nannette Jane Rogers Thornton, RD/CDE

Individual provider Active NPI Registered Dietitian · New Madrid, MO

NPI 1942530738 · NPPES record last updated Dec 30, 2009

Key facts

NPI
1942530738
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
Practice address
421 Line St
New Madrid, MO 63869-1733
Phone
(573) 748-2592
Fax
(573) 748-2673
NPI assigned
Dec 30, 2009
Sex
Female
Sole proprietor
No

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)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Health Network Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Yes

Addresses

Primary practice location

421 Line St
New Madrid, MO 63869-1733

Mailing address

311 Main St
New Madrid, MO 63869-1942
Phone (573) 748-2404

Other identifiers

IdentifierTypeStateIssuer
355856808MedicaidMO

Other providers in New Madrid, MO

All providers in New Madrid, MO · Registered Dietitian in Missouri

Sources for this page

Verify at the official NPI Registry.