Healthcare Provider Details

I. General information

NPI: 1437400512
Provider Name (Legal Business Name): ALLISON BERAN RIEDERER MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E 12TH ST STE 1
DURANGO CO
81301-5261
US

IV. Provider business mailing address

302 FIR DR
DURANGO CO
81301-7582
US

V. Phone/Fax

Practice location:
  • Phone: 970-239-1531
  • Fax:
Mailing address:
  • Phone: 970-239-1531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1090133
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: