Mack, Rosannah M.

Mack, Rosannah M. is an individual health care provider with primary practice located at 600 East Blvd Nutrition Services Department, Elkhart IN 46514-2483. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Mack, Rosannah M. can be contacted via phone (574) 523-3236.

Contact Information

Primary practice address
600 East Blvd Nutrition Services Department Elkhart IN 46514-2483
Phone: (574) 523-3236
Fax: (574) 296-6504
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 915393 Indiana

Profile Details

NPI number 1508924259
LBN Legal business name Mack, Rosannah M.
Credentials RD,CD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Apr 9th, 2009 - about 17 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 1508924259 NPPES
Indiana Other 915393 LICENSE
Indiana Other 37001470A LICENSE

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