| Jeanette Rae Ely, RDN | |
|
103 Fram Street, # 589, Petersburg, AK 99833 | |
| (907) 772-5730 | |
| (907) 772-3085 |
| Full Name | Jeanette Rae Ely |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 103 Fram Street, Petersburg, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952049157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 1003875 (Alaska) | Primary |
| Provider Name | The Petersburg Medical Center |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1437122843 PECOS PAC ID: 5395730626 Enrollment ID: O20040416000917 |
| Provider Name | The Petersburg Medical Center |
|---|---|
| Provider Type | Part A Provider - Critical Access Hospital |
| Provider Identifiers | NPI Number: 1437122843 PECOS PAC ID: 5395730626 Enrollment ID: O20061104000713 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeanette Rae Ely, RDN Po Box 1462, Petersburg, AK 99833-1462 Ph: (360) 510-2600 | Jeanette Rae Ely, RDN 103 Fram Street, # 589, Petersburg, AK 99833 Ph: (907) 772-5730 |
Margaret D Fleming, MS,RD,LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 103 Fram Street, Petersburg, AK 99833 Phone: 907-772-4291 Fax: 907-772-3085 | |
Audrey Miller, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 400 B Papkes Landing, Petersburg, AK 99833 Phone: 801-367-3786 |