Manczuk, Jade N.

Manczuk, Jade N. is an individual health care provider with primary practice located at 3231 S. National Suite 430, Springfield MO 65807. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Manczuk, Jade N. can be contacted via phone (417) 888-5660.

Contact Information

Primary practice address
3231 S. National Suite 430 Springfield MO 65807
Phone: (417) 888-5660
Fax: (417) 888-6793
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 2012024502 Missouri

Profile Details

NPI number 1124377395
LBN Legal business name Manczuk, Jade N.
Credentials RD, LD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 4th, 2012
Last updated Sep 4th, 2012 - about 14 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 1124377395 NPPES
Missouri Other 440552485 TRICARE

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