Provider Demographics
NPI:1013700830
Name:BEARD, DIERDRE (CNS, LDN)
Entity type:Individual
Prefix:
First Name:DIERDRE
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 FRENCH MOORE JR BLVD # 20
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-4738
Mailing Address - Country:US
Mailing Address - Phone:423-202-5685
Mailing Address - Fax:
Practice Address - Street 1:851 FRENCH MOORE JR BLVD # 20
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-4738
Practice Address - Country:US
Practice Address - Phone:423-202-5685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-24
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX7290133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist