Provider Demographics
NPI:1639565534
Name:LINDSAY BUCHHEIT NUTRITION SERVICES
Entity Type:Organization
Organization Name:LINDSAY BUCHHEIT NUTRITION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHHEIT
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:314-420-9669
Mailing Address - Street 1:39 CHAMPAGNE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1605
Mailing Address - Country:US
Mailing Address - Phone:314-226-3707
Mailing Address - Fax:
Practice Address - Street 1:39 CHAMPAGNE DR
Practice Address - Street 2:
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1605
Practice Address - Country:US
Practice Address - Phone:314-226-3707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-08
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009030630133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2009030630OtherMISSOURI LICENSE