Delagrange, Susan

Delagrange, Susan is an individual health care provider with primary practice located at 7916 W Jefferson Blvd , Fort Wayne IN 46804-4140. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Delagrange, Susan can be contacted via phone (260) 432-2297.

Contact Information

Primary practice address
7916 W Jefferson Blvd Fort Wayne IN 46804-4140
Fax: (260) 436-4380
Website:

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 37001523 Indiana

Profile Details

NPI number 1437118445
LBN Legal business name Delagrange, Susan
Credentials RDCD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Jul 8th, 2007 - about 19 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 1437118445 NPPES
Indiana Other 000000355286 ANTHEM

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