Provider Demographics
NPI:1114592672
Name:BESSER, KATHERINE VANDENBURGH (RDN LDN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:VANDENBURGH
Last Name:BESSER
Suffix:
Gender:F
Credentials:RDN LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 E 4TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52801-1713
Mailing Address - Country:US
Mailing Address - Phone:563-324-2828
Mailing Address - Fax:
Practice Address - Street 1:630 E 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52801-1713
Practice Address - Country:US
Practice Address - Phone:563-324-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01390133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered