Provider Demographics
NPI:1417658014
Name:RECKER, CARA (MS, RDN, LD, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:
Last Name:RECKER
Suffix:
Gender:F
Credentials:MS, RDN, LD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24551 201ST AVE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-8612
Mailing Address - Country:US
Mailing Address - Phone:515-509-3598
Mailing Address - Fax:
Practice Address - Street 1:24551 201ST AVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-8612
Practice Address - Country:US
Practice Address - Phone:515-509-3598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001883133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered