Provider Demographics
NPI:1518399310
Name:COOK, REBEKAH (RDN)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:FRANDSEN
Other - Last Name:HENNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 198
Mailing Address - Street 2:
Mailing Address - City:ORANGEVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84537-0198
Mailing Address - Country:US
Mailing Address - Phone:435-609-6765
Mailing Address - Fax:
Practice Address - Street 1:190 E 100 S
Practice Address - Street 2:
Practice Address - City:ORANGEVILLE
Practice Address - State:UT
Practice Address - Zip Code:84537-7850
Practice Address - Country:US
Practice Address - Phone:435-609-6765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT501375-4901133V00000X
CA858781133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered