Provider Demographics
NPI:1477946499
Name:BEEKER, LINDA (MS, RDN, CLT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:BEEKER
Suffix:
Gender:F
Credentials:MS, RDN, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6993 SUNBURST AVE
Mailing Address - Street 2:
Mailing Address - City:FIRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80504-6455
Mailing Address - Country:US
Mailing Address - Phone:972-998-4406
Mailing Address - Fax:
Practice Address - Street 1:6993 SUNBURST AVE
Practice Address - Street 2:
Practice Address - City:FIRESTONE
Practice Address - State:CO
Practice Address - Zip Code:80504-6455
Practice Address - Country:US
Practice Address - Phone:972-998-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83646133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered