Individual
CAMILLA PROVENCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
816 FEATHERSTONE RD, ROCKFORD, IL 61107-6300
(815) 227-0081
Mailing address
816 FEATHERSTONE RD, ROCKFORD, IL 61107-6300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/17/2025
Last updated
12/17/2025
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