Provider Demographics
NPI:1003031345
Name:ZWIEFEL, KRISTI DIANE (RD LD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:DIANE
Last Name:ZWIEFEL
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-1144
Mailing Address - Country:US
Mailing Address - Phone:515-532-3414
Mailing Address - Fax:515-532-3414
Practice Address - Street 1:720 3RD ST NE
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:IA
Practice Address - Zip Code:50525-1144
Practice Address - Country:US
Practice Address - Phone:515-532-3414
Practice Address - Fax:515-532-3414
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01090133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0142976Medicaid