Provider Demographics
NPI:1326181553
Name:BURBACH, JANETTE MARIE (RDN LDN CDE)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:MARIE
Last Name:BURBACH
Suffix:
Gender:F
Credentials:RDN LDN CDE
Other - Prefix:
Other - First Name:JANETTE
Other - Middle Name:MARIE
Other - Last Name:NEEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN LDN CDE
Mailing Address - Street 1:100 E COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-3702
Mailing Address - Country:US
Mailing Address - Phone:785-460-1430
Mailing Address - Fax:
Practice Address - Street 1:100 E COLLEGE DR
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-3702
Practice Address - Country:US
Practice Address - Phone:785-460-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE575133V00000X
KS2059133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2059OtherKANSAS DEPT FOR AGING AND DIABILITY SERVICES HEALTH OCCUPATIONS CREDENTIALING
NEP50905Medicare UPIN