Provider Demographics
NPI:1053654285
Name:MERIWETHER, BETH (MS,RD,LDN, HHC)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:
Last Name:MERIWETHER
Suffix:
Gender:F
Credentials:MS,RD,LDN, HHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2125
Mailing Address - Country:US
Mailing Address - Phone:484-832-1336
Mailing Address - Fax:610-544-4218
Practice Address - Street 1:600 W WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2125
Practice Address - Country:US
Practice Address - Phone:484-832-1336
Practice Address - Fax:610-544-4218
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-06
Last Update Date:2013-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005080133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered