Provider Demographics
NPI:1437819901
Name:BAIR, VERONICA (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:BAIR
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 6TH ST APT B1
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2526
Mailing Address - Country:US
Mailing Address - Phone:308-340-2098
Mailing Address - Fax:
Practice Address - Street 1:208 6TH ST APT B1
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2526
Practice Address - Country:US
Practice Address - Phone:308-340-2098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111839133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered