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Contact Information

JADE N MANCZUK, RD, LD
3231 S. NATIONAL
SUITE 430
SPRINGFIELD, MO65807
 Phone: 417-888-5660
 Fax: 417-888-6793
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for JADE N MANCZUK · (Female)

NPI Number 1124377395
Status Active
Credentials RD, LD
Entity Individual
Enumeration date 09/04/2012
Last updated 09/04/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2012024502
  • MO Other 440552485 TRICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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