Provider Demographics
NPI:1336602614
Name:ROSIER, RYANN RYCHELLE (RD)
Entity Type:Individual
Prefix:
First Name:RYANN
Middle Name:RYCHELLE
Last Name:ROSIER
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 1:705 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:MO
Mailing Address - Zip Code:64402-1433
Mailing Address - Country:US
Mailing Address - Phone:660-726-3941
Mailing Address - Fax:660-726-3647
Practice Address - Street 1:705 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:MO
Practice Address - Zip Code:64402-1433
Practice Address - Country:US
Practice Address - Phone:660-726-3941
Practice Address - Fax:660-726-3647
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013025399133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered