Healthcare Provider Details

I. General information

NPI: 1710804091
Provider Name (Legal Business Name): REBECCA PARSHALL RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 SE 11TH TER
LEES SUMMIT MO
64081-2153
US

IV. Provider business mailing address

809 SE 11TH TER
LEES SUMMIT MO
64081-2153
US

V. Phone/Fax

Practice location:
  • Phone: 816-718-6516
  • Fax:
Mailing address:
  • Phone: 816-718-6516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2356
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2018043140
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: