Provider Demographics
NPI:1780824326
Name:BIERDEMAN, ARIANNA LEIGH (RD)
Entity Type:Individual
Prefix:MRS
First Name:ARIANNA
Middle Name:LEIGH
Last Name:BIERDEMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 WEISENBERGER RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7993
Mailing Address - Country:US
Mailing Address - Phone:601-790-9098
Mailing Address - Fax:601-790-9098
Practice Address - Street 1:122 WEISENBERGER RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-7993
Practice Address - Country:US
Practice Address - Phone:601-790-9098
Practice Address - Fax:601-790-9098
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2012-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD1299133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0$$$$$$$$$OtherBLUE CROSS BLUE SHIELD