Organization
EVERGREEN HEALTH AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNAH A SCHRADER RD, LD, CDCES (OWNER/REGISTERED DIETITIAN)
(207) 838-5549
Entity
Organization
Contact information
Practice address
14919 PLATTSBURG RD, KEARNEY, MO 64060-8155
(207) 838-5549
Mailing address
14919 PLATTSBURG RD, KEARNEY, MO 64060-8155
(207) 838-5549
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
07/17/2023
Last updated
08/18/2023
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