Provider Demographics
NPI:1821339490
Name:TASLER, BROOKE (RD, LD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:TASLER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-2607
Mailing Address - Country:US
Mailing Address - Phone:712-265-2537
Mailing Address - Fax:712-265-2511
Practice Address - Street 1:100 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-2607
Practice Address - Country:US
Practice Address - Phone:712-265-2537
Practice Address - Fax:712-265-2511
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01708133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered