Fulayter, Jodi Anne
Fulayter, Jodi Anne is an sole proprietor health care provider with primary practice located at 2902 Campbell St , Joliet IL 60435-6492. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutritionist, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Fulayter, Jodi Anne can be contacted via phone (708) 261-3463.Contact Information
Primary practice address
2902 Campbell St
Joliet IL 60435-6492
Phone: (708) 261-3463
Fax: (815) 744-2707
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dietary & Nutritional Service Providers / Nutritionist | 133N00000X | 164003007 | Illinois |
Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | 164003007 | Illinois |
Profile Details
NPI number | 1629107495 |
---|---|
LBN Legal business name | Fulayter, Jodi Anne |
Credentials | Registered Dietitian (RD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Mar 5th, 2007 |
Last updated | Aug 9th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1629107495 | NPPES |
Illinois | Other | 09932114 | BLUE CROSS BLUE SHIELD |
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