Provider Demographics
NPI:1811059074
Name:HOENIG, ROSE (RD)
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:
Last Name:HOENIG
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 1:22685 GREAT RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LECLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753-9125
Mailing Address - Country:US
Mailing Address - Phone:563-320-1028
Mailing Address - Fax:
Practice Address - Street 1:22685 GREAT RIVER RD
Practice Address - Street 2:
Practice Address - City:LECLAIRE
Practice Address - State:IA
Practice Address - Zip Code:52753-9125
Practice Address - Country:US
Practice Address - Phone:563-320-1028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00047133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered