Healthcare Provider Details

I. General information

NPI: 1295849511
Provider Name (Legal Business Name): BELINDA RENAE KASPER R.D./L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 8TH RD
WILSON KS
67490-8717
US

IV. Provider business mailing address

136 8TH RD
WILSON KS
67490-8717
US

V. Phone/Fax

Practice location:
  • Phone: 785-483-6433
  • Fax: 785-483-3811
Mailing address:
  • Phone: 785-658-2276
  • Fax: 785-472-4953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number000043
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: