Provider Demographics
NPI:1528793403
Name:DANIELS, ELIZABETH EILEEN (RD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:EILEEN
Last Name:DANIELS
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 1:2805 NORTHWING DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-8623
Mailing Address - Country:US
Mailing Address - Phone:904-226-0247
Mailing Address - Fax:785-576-1146
Practice Address - Street 1:200 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-3049
Practice Address - Country:US
Practice Address - Phone:785-560-2566
Practice Address - Fax:785-576-1146
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-23
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2766133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty