MS. KIMBERLY G WALLANDER (NPI# 1891197711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891197711 |
| Entity Type | Individual |
| Full Name | MS. KIMBERLY G WALLANDER |
| Other Name | KIMBERLY A GUSTAFSON |
| Credential | R.D. |
| Practice Address |
450 Veterans Memorial Pkwy Ste 8c East Providence RI 02914-5300 |
| Practice Telephone | 4013969331 |
| Practice Fax Number | 4013969369 |
| Mailing Telephone | 4013969331 |
| Mailing Fax Number | 4013969369 |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2016-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | LDN00797 | RI | Dietary & Nutritional Service Providers |
| Street Address |
450 VETERANS MEMORIAL PKWY STE 8C |
| City | EAST PROVIDENCE |
| State | RI |
| Zip Code | 02914-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811595408 | Kelsey Irene Mcnulty | Dietitian, Registered | 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 | 2020-10-15 |
| 1649749714 | Mackenzie Anne Blair | Dietitian, Registered | 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 | 2018-11-19 |
| 1366910374 | Christina Bedetta Willett | Dietitian, Registered | 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 | 2018-11-07 |
| 1376053918 | Laura Elizabeth Dutra | Dietitian, Registered | 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 | 2017-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457988198 | Sean C. Duffy | Massage Therapist | 231 Warren Ave., East Providence, RI 02914 | 2020-03-24 |
| 1457905606 | Jeanine Le-kreuzer, Lmhc | Clinic/Center | 3421 Pawtucket Ave, East Providence, RI 02914 | 2019-07-26 |
| 1881113983 | Megan Grace Fitzpatrick | Student in an Organized Health Care Education/Training Program | 51 Milburn Rd, East Providence, RI 02914 | 2017-09-11 |
| 1265719660 | Hilary Elise Bicknell | Physical Therapist | 927 B Warren Ave, East Providence, RI 02914 | 2011-11-14 |
| 1346549037 | Amanda M Hope | Occupational Therapist | 2680 Pawtucket Ave, East Providence, RI 02914 | 2011-03-21 |
| 1780993824 | Shannon Hayes | Physical Therapist | 400 Massaoit Ave, East Providence, RI 02914 | 2010-10-06 |
| 1053623538 | Ricardo Rafael Correa Marquez | Internal Medicine | 900 Warren Avenue, Suite 300, East Providence, RI 02914 | 2010-07-13 |
| 1013231570 | Michael Seidler | Internal Medicine | 20 Catamore Blvd., East Providence, RI 02914 | 2010-03-26 |
| 1053543405 | Ray Rezania | Dentist | 1055 South Broadway, East Providence, RI 02914 | 2009-08-19 |
| 1144464587 | John F Maynard | Urology | Metacomet Office Park, 450 Veterans Parkway, East Providence, RI 02914 | 2009-04-29 |
| Find all providers in zip 02914 | ||||
| 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 |
|---|---|---|---|---|
| 1073129516 | Colby Thibault | Dietitian, Registered | 36 Captain John Jacobs Rd Apt 209, East Providence, RI 02914-5372 | 2020-09-21 |
| 1811595408 | Kelsey Irene Mcnulty | Dietitian, Registered | 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 | 2020-10-15 |
| 1265066492 | Hannah Eizabeth Masse | Dietitian, Registered | 450 Veterans Memorial Pkwy, East Providence, RI 02914-5300 | 2020-02-26 |
| 1649749714 | Mackenzie Anne Blair | Dietitian, Registered | 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 | 2018-11-19 |
| 1366910374 | Christina Bedetta Willett | Dietitian, Registered | 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 | 2018-11-07 |
| 1396235479 | Ashley Nicole Cotta | Dietitian, Registered | 950 Warren Ave Fl 2, East Providence, RI 02914-1432 | 2018-05-15 |
| 1376053918 | Laura Elizabeth Dutra | Dietitian, Registered | 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 | 2017-10-10 |
| 1063865368 | Sarah Dorothy Mosley | Dietitian, Registered | 450 Veterans Memorial Pkwy, 8c, East Providence, RI 02914-5300 | 2016-07-21 |
| 1700252988 | Christine Massella | Dietitian, Registered | 450 Veterans Memorial Pkwy, 8c, East Providence, RI 02914-5300 | 2015-08-11 |
| 1992190847 | Margaret Cromwell | Dietitian, Registered | 450 Veterans Memorial Pkwy, 8c, East Providence, RI 02914-5300 | 2015-03-30 |
| Find all providers in EAST PROVIDENCE | ||||
| City | EAST PROVIDENCE |
| Zip Code | 02914 |
Please comment or provide details below to improve the information on MS. KIMBERLY G WALLANDER.
| 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.