Provider Demographics
NPI:1508134172
Name:RICH, ROSEMARY M (RD LD)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:M
Last Name:RICH
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 1:1349 22ND RD NE
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:KS
Mailing Address - Zip Code:66871-9115
Mailing Address - Country:US
Mailing Address - Phone:620-256-6716
Mailing Address - Fax:
Practice Address - Street 1:1349 22ND RD NE
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:KS
Practice Address - Zip Code:66871-9115
Practice Address - Country:US
Practice Address - Phone:620-256-6716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS281133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered