Provider Demographics
NPI:1184826778
Name:LEHMAN, CONSTANCE A (RD)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:A
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7810 W 600 S
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:IN
Mailing Address - Zip Code:46571-9116
Mailing Address - Country:US
Mailing Address - Phone:260-336-3952
Mailing Address - Fax:
Practice Address - Street 1:101NS MAIN ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:IN
Practice Address - Zip Code:46571-9099
Practice Address - Country:US
Practice Address - Phone:260-593-2123
Practice Address - Fax:260-593-2150
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37001532A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM300063876OtherPTAN
INQ13833Medicare UPIN
INM300063876OtherPTAN