MS. MICHELLE GAUTREAUX (NPI# 1790727865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790727865 |
| Entity Type | Individual |
| Full Name | MS. MICHELLE GAUTREAUX |
| Credential | RDN/LDN |
| Practice Address |
325 Mdg 340 Magnolia Circle Tyndall Afb FL 32403 |
| Practice Telephone | 8502833826 |
| Mailing Telephone | 8502833826 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133N00000X | Nutritionist | Dietary & Nutritional Service Providers | ||
| Y | 133V00000X | Dietitian, Registered | ND3408 | FL | Dietary & Nutritional Service Providers |
| Street Address |
325 MDG 340 MAGNOLIA CIRCLE |
| City | TYNDALL AFB |
| State | FL |
| Zip Code | 32403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659937274 | Nathaniel Arthur Foster | Optometrist | 325 Mdg, 340 Magnolia Circle, Tyndall Afb, FL 32403-5604 | 2019-05-20 |
| 1386051761 | Gunnar Nelson | Family Medicine | 325 Mdg, 325 Mdg, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2014-07-17 |
| 1578875712 | Laura Wolfe | Pediatrics | 325 Mdg, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2010-07-03 |
| 1639336357 | Sean Alan Wilson | Physical Therapist | 325 Mdg, 340 Magnolia Circle, Tyndall Afb, FL 32403-5604 | 2008-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326408063 | Nathaniel Criddle | Dentist | 325 Aerospace Medicine Sq/sgpd, 340 Magnolia Circle Bldg 1465, Tyndall Afb, FL 32403 | 2016-02-23 |
| 1952730491 | Erick Laron Jackson | Physical Therapist | 325 Mdg/physical Therapy, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2013-11-05 |
| 1972830701 | Quan Tram | Pharmacist | 340 Magnolia Cirlcle, Tyndall Afb, FL 32403 | 2009-11-16 |
| 1952473308 | Robert Allen Frick | Family Medicine | 325th Medical Group 340 Magnolia Circle, Tyndall Afb, Panama City, FL 32403 | 2006-11-14 |
| 1285733907 | 325th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Magnolia Circle, Tyndall Afb, FL 32403 | 2006-09-21 |
| 1093737272 | Walter Edward Calvo | Social Worker | Bldg 1305 Suwannee Ave, Tyndall Afb, FL 32403 | 2006-07-24 |
| 1568436962 | 325 Mdg | Psychologist | 325 Mdg Bldg, 1305 Suwannee Ave, Tyndall Afb, FL 32403 | 2006-02-14 |
| 1780658005 | Brant Casford | Radiology | 325 Mdg/sgsar Radiology, Tyndall Afb, FL 32403 | 2006-02-14 |
| 1215911573 | Rama Bhyravabhotla | Physician Assistant | 325 Mdos/sgomf, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2005-12-01 |
| 1659355816 | Tracy Lynn Hunter | Specialist | Bldg 1404 Mississippi Rd, Panama City, FL 32403 | 2005-12-01 |
| Find all providers in zip 32403 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659748614 | Philip Webb | Dietitian, Registered | 325th Medical Group, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2015-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265268 | Rachel Moore Gibson | Dietitian, Registered | 5145 S Dale Mabry Hwy Unit 20412, Tampa, FL 33611-3677 | 2020-11-08 |
| 1275134520 | Dunia Santana-enamorado | Dietitian, Registered | 6141 Lanshire Dr, Tampa, FL 33634-3042 | 2020-11-03 |
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1114527256 | Jacquelyn Gabriela Baldeon Garo | Dietitian, Registered | 17701 Sw 112th Ave, Miami, FL 33157-5007 | 2020-10-28 |
| 1013516632 | Cecelia Lee Andreo | Dietitian, Registered | 3545 Victory Dr, Pace, FL 32571-8302 | 2020-10-24 |
| 1114526209 | Scientific Nutrition International LLC | Dietitian, Registered | 6295 Sunset Dr, South Miami, FL 33143-4804 | 2020-10-20 |
| 1023617446 | Madisyn Becker | Dietitian, Registered | 871 Ibis Walk Pl N Unit 7203, Saint Petersburg, FL 33716-3843 | 2020-10-19 |
| 1194323774 | Janice Cuevas Cintron | Dietitian, Registered | 5439 Limestone Ln, Lakeland, FL 33809-0830 | 2020-10-15 |
| 1194323345 | Danielle Sara Samelson | Dietitian, Registered | 4225 Cloverleaf Pl, Casselberry, FL 32707-4703 | 2020-10-10 |
| 1518564830 | Sneha Lalla | Dietitian, Registered | 14171 Metropolis Ave Ste 202, Fort Myers, FL 33912-4335 | 2020-10-08 |
| Find all providers with the same taxonomy | ||||
| City | TYNDALL AFB |
| Zip Code | 32403 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.