Mrs Georgia Fletcher Boley, MS,RD,LD,CSO | |
211 Smith St, Sheridan, WY 82801-3818 | |
(307) 752-8213 | |
(307) 675-1866 |
Full Name | Mrs Georgia Fletcher Boley |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 211 Smith St, Sheridan, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922432277 | NPI | - | NPPES |
156924 | Medicaid | WY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 87227 (Montana) | Secondary |
133V00000X | Dietitian, Registered | 084 (Wyoming) | Primary |
Provider Name | Tailored Nutrition Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1740605088 PECOS PAC ID: 8820229263 Enrollment ID: O20140327001015 |
Mailing Address | Practice Location Address |
---|---|
Mrs Georgia Fletcher Boley, MS,RD,LD,CSO 66 Box Cross Rd, Sheridan, WY 82801-9020 Ph: (307) 752-8213 | Mrs Georgia Fletcher Boley, MS,RD,LD,CSO 211 Smith St, Sheridan, WY 82801-3818 Ph: (307) 752-8213 |
Janet Nowak, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1898 Fort Road, Sheridan, WY 82801 Phone: 307-672-3473 | |
Ms. Chrystal Marie Frances Lopez, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1898 Fort Rd, Sheridan, WY 82801 Phone: 307-675-3837 | |
Simply Dietetics, Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 172 N Main St, Suite 1a, Sheridan, WY 82801 Phone: 208-866-2568 | |
Katherine Wells, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 30 N Gould St Ste R, Sheridan, WY 82801 Phone: 631-213-7190 Fax: 631-967-1698 | |
Mrs. Kathryn A. Redle, RD, CDE Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1898 Fort Rd, Va Medical Center (120), Sheridan, WY 82801 Phone: 307-672-3473 | |
Olivia Feaster, R.D., CSG , L.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1898 Fort Rd, Sheridan, WY 82801 Phone: 307-675-3837 | |
Mr. Greg R. Loftus, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1898 Fort Rd, Sheridan, WY 82801 Phone: 307-672-3473 |