Provider Demographics
NPI:1851881221
Name:BEALS, DANA MARIE (RD, CD)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MARIE
Last Name:BEALS
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 W GREEN RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-4327
Mailing Address - Country:US
Mailing Address - Phone:765-506-1581
Mailing Address - Fax:
Practice Address - Street 1:642 W GREEN RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-4327
Practice Address - Country:US
Practice Address - Phone:765-506-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered