Prairie View Creations Llc
Prairie View Creations Llc is a health care provider in Prescott, AZ. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location|| 8508 N Prairie Vw, Prescott Valley, AZ 86315-9089, US |
|Practice Location Phone||928-772-8652|
|Practice Location Fax||928-772-8078|
|Legal Business Name||PRAIRIE VIEW CREATIONS LLC|
|Enumeration Date ? ||Feb 27, 2019|
|Last Update Date ? ||Feb 27, 2019|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
Specialties & Licenses of Prairie View Creations Llc
|Specialty||Provider Type||Specialization||License||License State|
|Dietitian, Registered||Dietary & Nutritional Service Providers|| |
|Dietitian, Registered||Dietary & Nutritional Service Providers||Nutrition, Pediatric |
|Dietitian, Registered||Dietary & Nutritional Service Providers||Nutrition, Renal |
|Dietitian, Registered||Dietary & Nutritional Service Providers||Nutrition, Metabolic |
Legacy Provider IDs of Prairie View Creations Llc
|Provider Id||Issuer State||Issuer Type||Issuer|
Authorized Official of Prairie View Creations Llc
An authorized official is an appointed official with the legal authority to make changes and/or updates to the Prairie View Creations Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official || Chad Hetherwick (MS, RD)|
|Authorized Official Title/Position||REGISTERED DIETITIAN NUTRITIONIST|
|Authorized Official Phone Number||928-772-8652|