Provider Demographics
NPI:1871684480
Name:BIERSNER, MARTHA ANNE (RD LD MS)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:ANNE
Last Name:BIERSNER
Suffix:
Gender:F
Credentials:RD LD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1775 THOMPSON RD
Mailing Address - Street 2:BAY AREA HOSPITAL
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420
Mailing Address - Country:US
Mailing Address - Phone:541-269-8544
Mailing Address - Fax:541-269-8417
Practice Address - Street 1:1775 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420
Practice Address - Country:US
Practice Address - Phone:541-269-8544
Practice Address - Fax:541-269-8417
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
R119785Medicare UPIN
Q19315Medicare UPIN