Provider Demographics
NPI:1659981678
Name:REICHNER, KIRSTEN TARA MARQUIS (RD)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:TARA MARQUIS
Last Name:REICHNER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1557 SONNY DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-4203
Mailing Address - Country:US
Mailing Address - Phone:801-372-5538
Mailing Address - Fax:
Practice Address - Street 1:1557 SONNY DR
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-4203
Practice Address - Country:US
Practice Address - Phone:801-372-5538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT92349133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty