Provider Demographics
NPI:1427355130
Name:HOPE-RIEDESEL, DEBRA J (RD)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:J
Last Name:HOPE-RIEDESEL
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 1:5900 COLT DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7521
Mailing Address - Country:US
Mailing Address - Phone:515-225-1844
Mailing Address - Fax:
Practice Address - Street 1:5900 COLT DR
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7521
Practice Address - Country:US
Practice Address - Phone:515-225-1844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01613133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered