Provider Demographics
NPI:1598564924
Name:RIENKS, ALEXIS (RDN)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:RIENKS
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68523-9056
Mailing Address - Country:US
Mailing Address - Phone:402-202-7321
Mailing Address - Fax:
Practice Address - Street 1:7740 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68523-9056
Practice Address - Country:US
Practice Address - Phone:402-202-7321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86331009133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered