Courtney Tiemann, RD, LD
Individual provider Active NPI Registered Dietitian · Berkeley, MO
NPI 1124142815 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124142815
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2006027184 (MO)
- Practice address
- 6065 Helen Ave
Berkeley, MO 63134-2013 - Phone
- (314) 522-6410
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006027184 | MO | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2006027184 | MO | Yes |
Addresses
Primary practice location
6065 Helen Ave
Berkeley, MO 63134-2013
Mailing address
101 Brian Dr
Swansea, IL 62226-8013
Phone (618) 560-9924
Other providers in Berkeley, MO
- Cayla Christine Slaughter
- Philip Snipes
- Jeffrey Duane Snyder
- St. Louis County Government
- Joyce Theard
- Naomi N. Vance
- Erica Wilkins
- Sarah Woods
All providers in Berkeley, MO · Registered Dietitian in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.