Provider Demographics
NPI:1679853246
Name:ROEHRICH, RACHEL I (RD, LRD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:I
Last Name:ROEHRICH
Suffix:
Gender:F
Credentials:RD, LRD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:I
Other - Last Name:CLAUSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LRD
Mailing Address - Street 1:PO BOX 5501
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58506-5501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 N 7TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4439
Practice Address - Country:US
Practice Address - Phone:701-323-5682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND843133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered