Burt, Jody Jeanne Johnson

Burt, Jody Jeanne Johnson is an individual health care provider with primary practice located at 2501 W 26Th St , Sioux Falls SD 57105-2446. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Burt, Jody Jeanne Johnson can be contacted via phone (605) 444-9532.

Contact Information

Primary practice address
2501 W 26Th St Sioux Falls SD 57105-2446
Phone: (605) 444-9532
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 0544 South Dakota

Profile Details

NPI number 1811938459
LBN Legal business name Burt, Jody Jeanne Johnson
Credentials MA, RDN, LN, CNSC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Oct 15th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811938459 NPPES
South Dakota Other 0544 SD BOARD OF MEDICAL & OSTEOPATHIC EXAMINER LICENSE NUMBER
South Dakota Other 870348 SD BOARD OF MEDICAL & OSTEOPATHIC EXAMINER LICENSE NUMBER

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