Provider Demographics
NPI:1679209498
Name:HARPER-BEUTEL, SIERRA ELIZABETH (RDN)
Entity Type:Individual
Prefix:MISS
First Name:SIERRA
Middle Name:ELIZABETH
Last Name:HARPER-BEUTEL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BENCH ST
Mailing Address - Street 2:
Mailing Address - City:LYNXVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54626-7146
Mailing Address - Country:US
Mailing Address - Phone:608-712-6548
Mailing Address - Fax:
Practice Address - Street 1:37868 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU CHIEN
Practice Address - State:WI
Practice Address - Zip Code:53821-8416
Practice Address - Country:US
Practice Address - Phone:608-357-2219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5004133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI500429OtherDEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES