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Individual

MRS. REBECCA L KRATOCHVIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, CD

Contact information

Practice address
600 EAST BLVD, NUTRITION SERVICES DEPT., ELKHART, IN 46514-2483
(574) 523-3236
(574) 296-6504
Mailing address
PO BOX 660376, EGH INSURANCE PAYMENTS, INDIANAPOLIS, IN 46266-0376
(574) 523-3148
(574) 523-3492

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
915551
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37001686A
IN STATE CERTIFICATION NU
IN
Enumeration date
12/11/2006
Last updated
10/19/2010
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