| Ms Daniela Novotny, RD | |
|
1500 N Oakland Ave, Bolivar, MO 65613-3011 | |
| (417) 328-6737 | |
| (417) 328-6649 |
| Full Name | Ms Daniela Novotny |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 1500 N Oakland Ave, Bolivar, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467695304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 2006029444 (Missouri) | Primary |
| Provider Name | Missouri State University |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073600334 PECOS PAC ID: 7214919661 Enrollment ID: O20040601001151 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Daniela Novotny, RD 2236 W Springlane St, Springfield, MO 65807-4036 Ph: (417) 883-5122 | Ms Daniela Novotny, RD 1500 N Oakland Ave, Bolivar, MO 65613-3011 Ph: (417) 328-6737 |
Grace Cidlik, MS, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1500 N. Oakland, Bolivar, MO 65613 Phone: 417-326-6000 | |
Mesha Cowan, RDN, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1500 N Oakland Ave, Bolivar, MO 65613 Phone: 417-328-6752 | |
Mr. Xavier Jacob Lee Pearson, MS, RD, LD, CNSC Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1500 N Oakland Ave, Bolivar, MO 65613 Phone: 417-328-6462 | |
Austin Gott, MS, RDN, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1500 N Oakland Ave, Bolivar, MO 65613 Phone: 417-326-6000 | |
Lynetta S Smith, MS, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1500 N Oakland Ave, Bolivar, MO 65613 Phone: 417-326-6000 | |
Deborah J Thompson, R.D., L.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1500 N Oakland Ave, Bolivar, MO 65613 Phone: 417-328-6462 Fax: 417-328-6654 |