Provider Demographics
NPI:1164669271
Name:LINDERBLOOD, DEBRA SL (RD)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:SL
Last Name:LINDERBLOOD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:SL
Other - Last Name:LANGE NEUBAUER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:REGISTERED DIETITIAN
Mailing Address - Street 1:640 SOUTH 19TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201
Mailing Address - Country:US
Mailing Address - Phone:515-382-2111
Mailing Address - Fax:515-382-7760
Practice Address - Street 1:640 SOUTH 19TH ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201
Practice Address - Country:US
Practice Address - Phone:515-382-2111
Practice Address - Fax:515-382-7760
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00223133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered