Basic Information
| Provider Information | |||||||||
| NPI: | 1437495850 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FUEHRING | ||||||||
| FirstName: | JANA | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1005 S BISMARK ST | ||||||||
| Address2: | PO BOX 853 | ||||||||
| City: | CONCORDIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640209366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8168380531 | ||||||||
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| Practice Location | |||||||||
| Address1: | 105 E HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | SWEET SPRINGS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 653512229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6603357416 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2012 | ||||||||
| LastUpdateDate: | 12/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 2005032828 | MO | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.