Provider Demographics
NPI:1104024306
Name:LOSEY, RICHARD A (RD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:LOSEY
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 WOOLWORTH AVE
Mailing Address - Street 2:MAIL STOP 120
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1850
Mailing Address - Country:US
Mailing Address - Phone:402-346-8800
Mailing Address - Fax:402-977-5603
Practice Address - Street 1:4101 WOOLWORTH AVE
Practice Address - Street 2:MAIL STOP 120
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1850
Practice Address - Country:US
Practice Address - Phone:402-346-8800
Practice Address - Fax:402-977-5603
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
966674133V00000X
NE840133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered