Mia L Funcheon, RDN | |
842 Durham Rd Ste 200, Newtown, PA 18940-9680 | |
(267) 364-5396 | |
Not Available |
Full Name | Mia L Funcheon |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 842 Durham Rd Ste 200, Newtown, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477279594 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Provider Name | Nashville Nutrition Partners |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1790268506 PECOS PAC ID: 8224378963 Enrollment ID: O20190316000096 |
Mailing Address | Practice Location Address |
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Mia L Funcheon, RDN 842 Durham Rd Ste 200, Newtown, PA 18940-9680 Ph: () - | Mia L Funcheon, RDN 842 Durham Rd Ste 200, Newtown, PA 18940-9680 Ph: (267) 364-5396 |
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