Provider Demographics
NPI:1295849511
Name:KASPER, BELINDA RENAE (RD/LD)
Entity Type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:RENAE
Last Name:KASPER
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 1:136 8TH RD
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:KS
Mailing Address - Zip Code:67490-8717
Mailing Address - Country:US
Mailing Address - Phone:785-658-2276
Mailing Address - Fax:785-472-4953
Practice Address - Street 1:136 8TH RD
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:KS
Practice Address - Zip Code:67490-8717
Practice Address - Country:US
Practice Address - Phone:785-483-6433
Practice Address - Fax:785-483-3811
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS000043133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100210550CMedicaid
KS100210550EMedicaid
KS130562Medicare ID - Type Unspecified