Individual
SUSAN R WILLYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DIETITIAN
Contact information
Practice address
42 6TH AVE SE, UNION HOSPITAL, MAYVILLE, ND 58257
(701) 788-3800
(701) 788-2145
Mailing address
42 6TH AVE SE, UNION HOSPITAL, MAYVILLE, ND 58257
(701) 788-3800
(701) 788-2145
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
182
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14397
BLUE SHIELD
—
Enumeration date
10/16/2006
Last updated
07/08/2007
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