Provider Demographics
NPI:1770607848
Name:DEMERS, BRENDA (RD)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:DEMERS
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 1:2298 CLOVER FIELD DR
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-3213
Mailing Address - Country:US
Mailing Address - Phone:952-220-3771
Mailing Address - Fax:
Practice Address - Street 1:2298 CLOVER FIELD DR
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-3213
Practice Address - Country:US
Practice Address - Phone:952-220-3771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered