Provider Demographics
NPI:1205039054
Name:FELLOWS, LINDA ANN (RD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:FELLOWS
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 1:500 N. 5TH STREET
Mailing Address - Street 2:BHHCS - NFS TELEHEALTH
Mailing Address - City:HOT SPRINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57747
Mailing Address - Country:US
Mailing Address - Phone:605-745-2000
Mailing Address - Fax:605-745-7206
Practice Address - Street 1:500 N 5TH ST
Practice Address - Street 2:BHHCS, NFS- TELEHEALTH
Practice Address - City:HOT SPRINGS
Practice Address - State:SD
Practice Address - Zip Code:57747-1480
Practice Address - Country:US
Practice Address - Phone:605-745-2000
Practice Address - Fax:605-745-7206
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1205039054OtherPRIVIATE INSURANCE