Provider Demographics
NPI:1679026132
Name:WOODINGTON, BETH (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:WOODINGTON
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 RALSTON ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-5315
Mailing Address - Country:US
Mailing Address - Phone:260-417-6563
Mailing Address - Fax:
Practice Address - Street 1:325 MAINE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1360
Practice Address - Country:US
Practice Address - Phone:785-505-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2483133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered