Evetha Malcolm-theriault, RD is a
Dietitian, Registered based in Pueblo, Co 81004, Colorado. Evetha Malcolm-theriault is licensed to practice in Alaska (license number DTND346) and her current practice location is
1008 Minnequa Ave, St. Mary-corwin Medical Center /diabetes Health Center, Pueblo, Co 81004, Colorado. She can be reached at her office (for appointments etc.) via phone at
(719) 557-5955.
NPI number for Evetha Malcolm-theriault is 1659891521 and her current mailing address is 1008 Minnequa Ave Rm 4206, Pueblo, Colorado. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1659891521.
Healthcare Provider's Profile
Full Name | Evetha Malcolm-theriault |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 1008 Minnequa Ave, Pueblo, Co 81004, Colorado |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1659891521
- Provider Enumeration Date: 06/22/2017
- Last Update Date: 06/22/2017
Medical Identifiers
Medical identifiers for Evetha Malcolm-theriault such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1659891521 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | DTND346 (Alaska) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evetha Malcolm-theriault is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Evetha Malcolm-theriault, RD 1008 Minnequa Ave Rm 4206, Pueblo, CO 81004-3733 Ph: (719) 557-5955 | Evetha Malcolm-theriault, RD 1008 Minnequa Ave, St. Mary-corwin Medical Center /diabetes Health Center, Pueblo, Co 81004, CO 81004 Ph: (719) 557-5955 |
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