Provider Demographics
NPI:1154198802
Name:BOYER, RACHEL TETLIE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:TETLIE
Last Name:BOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:RICE
Other - Last Name:TETLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN, LD
Mailing Address - Street 1:16221 WESTGATE TRL
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-1851
Mailing Address - Country:US
Mailing Address - Phone:651-402-3882
Mailing Address - Fax:
Practice Address - Street 1:16221 WESTGATE TRL
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-1851
Practice Address - Country:US
Practice Address - Phone:651-402-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4655133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered