Provider Demographics
NPI:1972730398
Name:ADENT, BETHANY (RD)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:
Last Name:ADENT
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 1:11992 TYRA CT
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-1528
Mailing Address - Country:US
Mailing Address - Phone:314-556-2325
Mailing Address - Fax:
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:MAILSTOP 90-17-334
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-362-4956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007008243133V00000X
IL164005115133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered