Provider Demographics
NPI:1376507160
Name:SCHMEISSNER, BARETTA G (RD)
Entity Type:Individual
Prefix:MRS
First Name:BARETTA
Middle Name:G
Last Name:SCHMEISSNER
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 1:1919 FISHER ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY FALLS
Mailing Address - State:KS
Mailing Address - Zip Code:66088-9791
Mailing Address - Country:US
Mailing Address - Phone:785-350-3111
Mailing Address - Fax:
Practice Address - Street 1:2200 SW GAGE BLVD
Practice Address - Street 2:BLUE TEAM/PC 11
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66622-0001
Practice Address - Country:US
Practice Address - Phone:785-350-3111
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS552133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered