Organization
MICHIANA NUTRITION AND DIABETES EDUCATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANOUK D SHELTON MBA, RD, LD, CNSC (REGISTERED DIETITIAN)
(815) 342-6205
Entity
Organization
Contact information
Practice address
300 S SAINT LOUIS BLVD, SOUTH BEND, IN 46617-3043
(574) 301-5205
(574) 301-5205
Mailing address
16151 PETRO DR, MISHAWAKA, IN 46544-6422
(815) 342-6205
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
10/25/2022
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