Leanne Renee Donovan, MS, RD, LD
Individual provider Active NPI Registered Dietitian · Saint Louis, MO
NPI 1124308648 · NPPES record last updated Oct 9, 2013
Key facts
- NPI
- 1124308648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2010012940 (MO)
- Practice address
- 705 Brownell Ave
Saint Louis, MO 63122-3234 - Phone
- (314) 623-9946
- NPI assigned
- Aug 29, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010012940 | MO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward W Heidbrier MD PC | Past | Accepting new patients | |
| Midwest Medical Supply Co LLC | Past | Accepting new patients | |
| Dsi Midwest Associates, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2010012940 | MO | Yes |
Addresses
Primary practice location
705 Brownell Ave
Saint Louis, MO 63122-3234
Mailing address
705 Brownell Ave
Saint Louis, MO 63122-3234
Phone (314) 623-9946
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861674871 | Other | MO | INSIGHT DIETITIANS |
Other providers in Saint Louis, MO
- Patrick Stephen Donohue
- Analise Marie Donovan
- Colleen E Donovan
- Emily Claire Donovan
- Julia Donovan
- Mary Margaret (Peggy Donovan
- Michael Donovan
- Nathan Donovan
- Samantha Donovan
- Thomas J Donovan
All providers in Saint Louis, 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 Oct 9, 2013. 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.