Provider Demographics
NPI:1912305871
Name:FISHER, JULIE RACHELE (RD, LDN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:RACHELE
Last Name:FISHER
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HIGHLAND AVE
Mailing Address - Street 2:CLINICAL NUTRITION SERVICES
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1167
Mailing Address - Country:US
Mailing Address - Phone:717-248-5411
Mailing Address - Fax:717-242-7255
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:CLINICAL NUTRITION SERVICES
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1167
Practice Address - Country:US
Practice Address - Phone:717-248-5411
Practice Address - Fax:717-242-7255
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001525133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered