Provider Demographics
NPI:1457644247
Name:DIERKHISING, BETH ANN (RD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:DIERKHISING
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 1:1825 WOODWINDS DR
Mailing Address - Street 2:OAK CENTER- WOODWINDS HEALTH CAMPUS
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2202
Mailing Address - Country:US
Mailing Address - Phone:651-326-0148
Mailing Address - Fax:
Practice Address - Street 1:1825 WOODWINDS DR
Practice Address - Street 2:OAK CENTER- WOODWINDS HEALTH CAMPUS
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2202
Practice Address - Country:US
Practice Address - Phone:651-326-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered