Individual
STACEY BOLANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, RN
Contact information
Practice address
5510 S EAST ST STE H, INDIANAPOLIS, IN 46227-1938
(317) 924-8425
Mailing address
5946 ALDRIDGE DR, WHITESTOWN, IN 46075-4419
(317) 506-0814
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37000665
IN
Other
Enumeration date
10/12/2019
Last updated
10/12/2019
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