Provider Demographics
NPI:1922396191
Name:MUELLER, MICHELLE ANN (RD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:MUELLER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 FIRETHORNE PL APT 108
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-3354
Mailing Address - Country:US
Mailing Address - Phone:909-921-5955
Mailing Address - Fax:
Practice Address - Street 1:1800 FIRETHORNE PLANCE
Practice Address - Street 2:APT. 108
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881
Practice Address - Country:US
Practice Address - Phone:909-921-5955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered