Provider Demographics
NPI:1346646569
Name:PIRKLE, SUZANNE (MA,RD,LD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:PIRKLE
Suffix:
Gender:F
Credentials:MA,RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 AUTUMN LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5209
Mailing Address - Country:US
Mailing Address - Phone:205-317-4111
Mailing Address - Fax:205-536-6223
Practice Address - Street 1:4126 AUTUMN LN
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5209
Practice Address - Country:US
Practice Address - Phone:205-317-4111
Practice Address - Fax:205-536-6223
Is Sole Proprietor?:No
Enumeration Date:2014-11-16
Last Update Date:2014-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1807133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered