Individual
MS. PENNY JEAN ATKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., C.D.E
Contact information
Practice address
4930 ILLINOIS RD, FORT WAYNE, IN 46804-5105
(260) 341-2923
Mailing address
14610 WATERBROOK RD, FORT WAYNE, IN 46814-9142
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001912A
IN
Other
Enumeration date
06/03/2011
Last updated
06/03/2011
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