Individual
MRS. DIEDRE PULVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1234 E DUPONT RD STE 6, FORT WAYNE, IN 46825-1545
(260) 425-6390
(260) 425-6395
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
37003609A
IN
Other
Enumeration date
01/06/2023
Last updated
08/30/2023
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