Provider Demographics
NPI:1912259938
Name:DYSON, JULIE (RD)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:DYSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 E PRATER WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-8969
Mailing Address - Country:US
Mailing Address - Phone:775-352-6683
Mailing Address - Fax:775-352-6616
Practice Address - Street 1:1625 E PRATER WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-8969
Practice Address - Country:US
Practice Address - Phone:775-352-6683
Practice Address - Fax:775-352-6616
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered