Provider Demographics
NPI:1316304439
Name:LINSENMEYER, WHITNEY RILEY (RD, LD)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:RILEY
Last Name:LINSENMEYER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:RILEY
Other - Last Name:KLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:1 N GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-2006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3518 LACLEDE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-2011
Practice Address - Country:US
Practice Address - Phone:314-977-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011035397133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered