Provider Demographics
NPI:1730443029
Name:RUEDEL, BARBARA SUSAN (RD)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:SUSAN
Last Name:RUEDEL
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 1:7413 FIELDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-2508
Mailing Address - Country:US
Mailing Address - Phone:502-744-6349
Mailing Address - Fax:
Practice Address - Street 1:7413 FIELDSTONE WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-2508
Practice Address - Country:US
Practice Address - Phone:502-744-6341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY706271133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered