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
Fax: (815) 744-2707
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629107495 NPPES
Illinois Other 09932114 BLUE CROSS BLUE SHIELD

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