Provider Demographics
NPI:1528517745
Name:PEARSON, ASHLEY (MBA, RDN, LDN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MBA, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3290 RIDGEWAY DRIVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2021
Mailing Address - Country:US
Mailing Address - Phone:319-665-2630
Mailing Address - Fax:319-665-2631
Practice Address - Street 1:3290 RIDGEWAY DR STE 3
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2023
Practice Address - Country:US
Practice Address - Phone:319-665-2630
Practice Address - Fax:319-665-2631
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA085951133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered