Provider Demographics
NPI:1366530206
Name:RIESMAN, DENISE LEE (RD,CDE)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:LEE
Last Name:RIESMAN
Suffix:
Gender:F
Credentials:RD,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 HOLMES RD
Mailing Address - Street 2:SUITE 550
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1150
Mailing Address - Country:US
Mailing Address - Phone:816-276-9410
Mailing Address - Fax:816-523-3693
Practice Address - Street 1:6675 HOLMES RD
Practice Address - Street 2:SUITE 550
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1150
Practice Address - Country:US
Practice Address - Phone:816-276-9410
Practice Address - Fax:816-523-3693
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004019815133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1194799916OtherCORPORATE NPI KC INTERNAL