Tracy Lynn Konoske, MS, RD, LD

Individual provider Active NPI Registered Dietitian · Laurel, MT

NPI 1972626596 · NPPES record last updated May 10, 2011

Key facts

NPI
1972626596
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
410 (MT)
Practice address
71 Bus LN
Laurel, MT 59044-9214
Phone
(406) 534-9405
Fax
(406) 333-7190
NPI assigned
Apr 9, 2007
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)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
410MTMDMedical Technologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 410 MT Yes

Addresses

Primary practice location

71 Bus LN
Laurel, MT 59044-9214

Mailing address

71 Bus LN
Laurel, MT 59044-9214
Phone (406) 534-9405

Other providers in Laurel, MT

All providers in Laurel, MT · Registered Dietitian in Montana

Sources for this page

Verify at the official NPI Registry.