Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ANNIKA LENORE DOUGHERTY IMELLI, RD, IBCLC
Active Sole ProprietorANNIKA LENORE DOUGHERTY IMELLI, RD, IBCLC is a Registered Dietitian healthcare provider located in POLARIS, Montana. NPI 1194411447 is currently active in the NPPES registry. Verify at CMS.
Registered Dietitian · POLARIS, MT
Registration Details
- NPI Number
- 1194411447
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 11, 2023 (3.3609371589792 yrs)
- Last Updated
- Jan 3, 2025
- Licenses
-
L-21954MED-NUT-LIC-125402 (MT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
141 ASPEN VIEW RDPOLARIS, MT, 59746Browse MT providers · Browse ZIP 59746
- Phone
- 4156069558
- Primary Specialty
-
Registered Dietitian
133V00000X
- Additional Specialty
- Registered Dietitian
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.