Provider Demographics
NPI:1104158674
Name:RIEDL, MARGARET ANN (RD LD CDE)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:RIEDL
Suffix:
Gender:F
Credentials:RD LD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 LUBERON DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-0361
Mailing Address - Country:US
Mailing Address - Phone:702-239-2156
Mailing Address - Fax:
Practice Address - Street 1:5701 W CHARLESTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1256
Practice Address - Country:US
Practice Address - Phone:702-877-9514
Practice Address - Fax:702-312-3510
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
528673133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV31996DI-0OtherSTATE OF NV LICENSURE
528673OtherREGISTERED DIETITIAN
0922-4425OtherCERTIFIED DIABETES EDUCATOR