Individual
GENA BAISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8727
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8727
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84565
TX
Other
Enumeration date
09/04/2020
Last updated
10/02/2024
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