Provider Demographics
NPI:1255938213
Name:ALJETS, ANNETTE ARNAUD (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:ARNAUD
Last Name:ALJETS
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 1:63368 190TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMEROY
Mailing Address - State:IA
Mailing Address - Zip Code:50575-8051
Mailing Address - Country:US
Mailing Address - Phone:515-574-9689
Mailing Address - Fax:
Practice Address - Street 1:63368 190TH AVE
Practice Address - Street 2:
Practice Address - City:POMEROY
Practice Address - State:IA
Practice Address - Zip Code:50575-8051
Practice Address - Country:US
Practice Address - Phone:515-574-9689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01405133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered