Provider Demographics
NPI:1992209597
Name:RUBLE, WHITNEY (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:RUBLE
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S COULTER ST STE 413
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1766
Mailing Address - Country:US
Mailing Address - Phone:806-677-7952
Mailing Address - Fax:
Practice Address - Street 1:1301 S COULTER ST STE 413
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1766
Practice Address - Country:US
Practice Address - Phone:806-677-7952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT85261133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty