Provider Demographics
NPI:1679267314
Name:SAVAGEAU, LEANNE JORDYN (RD)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:JORDYN
Last Name:SAVAGEAU
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:LEANNE
Other - Middle Name:JORDYN
Other - Last Name:BEECHIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1461 BROADWAY N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102
Mailing Address - Country:US
Mailing Address - Phone:701-293-6037
Mailing Address - Fax:701-293-0242
Practice Address - Street 1:1461 BROADWAY N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102
Practice Address - Country:US
Practice Address - Phone:701-293-6037
Practice Address - Fax:701-293-0242
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1122133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered