Provider Demographics
NPI:1194556316
Name:FUELING FERTILITY LLC
Entity type:Organization
Organization Name:FUELING FERTILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CELINE
Authorized Official - Middle Name:MUKEYINA
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LN
Authorized Official - Phone:605-496-8068
Mailing Address - Street 1:PO BOX 511
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:SD
Mailing Address - Zip Code:57268-0511
Mailing Address - Country:US
Mailing Address - Phone:605-496-8068
Mailing Address - Fax:
Practice Address - Street 1:650 OAHE AVE
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:SD
Practice Address - Zip Code:57268-2028
Practice Address - Country:US
Practice Address - Phone:605-496-8068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty