Provider Demographics
NPI:1497273734
Name:REESE, ASHLEY (RDN, LMNT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:RDN, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17810 WELCH PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-1620
Mailing Address - Country:US
Mailing Address - Phone:402-896-4168
Mailing Address - Fax:
Practice Address - Street 1:17810 WELCH PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-1620
Practice Address - Country:US
Practice Address - Phone:402-896-4168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1319133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered