Provider Demographics
NPI:1003355793
Name:RUMLER, GINETTE YVONNE (RDN, LDN, CLC)
Entity Type:Individual
Prefix:MRS
First Name:GINETTE
Middle Name:YVONNE
Last Name:RUMLER
Suffix:
Gender:F
Credentials:RDN, LDN, CLC
Other - Prefix:MISS
Other - First Name:GINETTE
Other - Middle Name:YVONNE
Other - Last Name:MATHIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LDN
Mailing Address - Street 1:406 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-3407
Mailing Address - Country:US
Mailing Address - Phone:815-632-6200
Mailing Address - Fax:815-632-6201
Practice Address - Street 1:406 AVENUE C
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-3407
Practice Address - Country:US
Practice Address - Phone:815-632-6200
Practice Address - Fax:815-632-6201
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.001729133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered