| Beverly Fountain, | |
|
20930 Dupont Blvd Unit 202, Georgetown, DE 19947-1724 | |
| (302) 856-3737 | |
| Not Available |
| Full Name | Beverly Fountain |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 10 Years |
| Location | 20930 Dupont Blvd Unit 202, Georgetown, Delaware |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225750813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133VN1201X | Dietitian, Registered - Nutrition, Obesity And Weight Management | DN-0010985 (Delaware) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tidalhealth Physician Network, Inc. | 7315901253 | 115 |
| Provider Name | Tidalhealth Physician Network, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1467534636 PECOS PAC ID: 7315901253 Enrollment ID: O20041119000090 |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Fountain, 20930 Dupont Blvd Unit 101, Georgetown, DE 19947-1723 Ph: Not Available | Beverly Fountain, 20930 Dupont Blvd Unit 202, Georgetown, DE 19947-1724 Ph: (302) 856-3737 |
Kelsey Elizabeth Mcmunn, MS, RDN, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 20930 Dupont Blvd Unit 202, Georgetown, DE 19947 Phone: 302-202-3438 |
Laura Ames, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 22401 Park Ave, Georgetown, DE 19947 Phone: 302-841-2421 |
Taylor M Domann, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 20930 Dupont Blvd, Georgetown, DE 19947 Phone: 302-202-3438 |
Lynleigh Palmer, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 14280 Brandy Ln, Georgetown, DE 19947 Phone: 856-472-2555 |
Shawnee Seitz, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 26026 Patriots Way, Georgetown, DE 19947 Phone: 302-542-5169 |
Jaclyn Elise Wahner, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 20930 Dupont Blvd Unit 202, Georgetown, DE 19947 Phone: 302-202-3438 |
Madison Lei Hines, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 20930 Dupont Blvd Unit 202, Georgetown, DE 19947 Phone: 302-202-3438 |