Provider Demographics
NPI:1689062796
Name:BARKER, EMILY (RD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:SHOEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 WEST ST S
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-8117
Mailing Address - Country:US
Mailing Address - Phone:641-236-6584
Mailing Address - Fax:641-236-4920
Practice Address - Street 1:320 WEST ST S
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-8117
Practice Address - Country:US
Practice Address - Phone:641-236-6584
Practice Address - Fax:641-236-4920
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-26
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA86010901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered