Provider Demographics
NPI:1477300614
Name:KRUZLIAKOVA, NATALIE (PHD, RDN, LD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:KRUZLIAKOVA
Suffix:
Gender:F
Credentials:PHD, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4408 W FRIAR DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-2470
Mailing Address - Country:US
Mailing Address - Phone:540-798-2341
Mailing Address - Fax:
Practice Address - Street 1:4408 W FRIAR DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-2470
Practice Address - Country:US
Practice Address - Phone:540-798-2341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered