Provider Demographics
NPI:1427381870
Name:TORKELSON, TANNA (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:TANNA
Middle Name:
Last Name:TORKELSON
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 1:7173 DEER RUN DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-2549
Mailing Address - Country:US
Mailing Address - Phone:440-786-5006
Mailing Address - Fax:
Practice Address - Street 1:7173 DEER RUN DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-2549
Practice Address - Country:US
Practice Address - Phone:440-786-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6313133V00000X
OH977180133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered