Healthcare Provider Details

I. General information

NPI: 1427524610
Provider Name (Legal Business Name): RACHEL IVERSON SCHAFER RD RDW LRD CSSD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL MARIE IVERSON RD LRD

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 HEART RIVER DR S
MANDAN ND
58554
US

IV. Provider business mailing address

1610 HEART RIVER DR S
MANDAN ND
58554-5801
US

V. Phone/Fax

Practice location:
  • Phone: 701-220-4421
  • Fax:
Mailing address:
  • Phone: 701-220-4421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1172
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code133VN1501X
TaxonomySports Dietetics Nutrition Registered Dietitian
License Number86066973
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: