Provider Demographics
NPI:1093513152
Name:WEIHE, KAILA REBECCA (RDN)
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:REBECCA
Last Name:WEIHE
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 N DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:FULDA
Mailing Address - State:MN
Mailing Address - Zip Code:56131-9469
Mailing Address - Country:US
Mailing Address - Phone:605-360-4054
Mailing Address - Fax:
Practice Address - Street 1:103 N DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FULDA
Practice Address - State:MN
Practice Address - Zip Code:56131-9469
Practice Address - Country:US
Practice Address - Phone:605-360-4054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5178133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered