Provider Demographics
NPI:1265838205
Name:HINDERAKER, ERIN (RD, LD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HINDERAKER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:STORY CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50248-1133
Mailing Address - Country:US
Mailing Address - Phone:515-230-6644
Mailing Address - Fax:
Practice Address - Street 1:527 BROAD ST
Practice Address - Street 2:
Practice Address - City:STORY CITY
Practice Address - State:IA
Practice Address - Zip Code:50248-1133
Practice Address - Country:US
Practice Address - Phone:515-230-6644
Practice Address - Fax:515-335-2081
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001926133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered