Provider Demographics
NPI:1063517530
Name:BUHLER, JOYCE F (RD CD CDE)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:F
Last Name:BUHLER
Suffix:
Gender:F
Credentials:RD CD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 W 200 N
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-1907
Mailing Address - Country:US
Mailing Address - Phone:435-789-3342
Mailing Address - Fax:435-781-6886
Practice Address - Street 1:151 W 200 N
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-1907
Practice Address - Country:US
Practice Address - Phone:435-789-3342
Practice Address - Fax:435-781-6886
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1059604901133V00000X
IL0992-078 CDE133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT621762532033Medicaid
UT460030Medicare Oscar/Certification