Provider Demographics
NPI:1346125838
Name:KIELAS, BETH (RDN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:KIELAS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:SANDLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:5814 DENDRON LN
Mailing Address - Street 2:
Mailing Address - City:GREENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53129-2363
Mailing Address - Country:US
Mailing Address - Phone:414-737-4322
Mailing Address - Fax:
Practice Address - Street 1:3809 SPRING ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53405-1667
Practice Address - Country:US
Practice Address - Phone:262-687-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2411-29133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered