Provider Demographics
NPI:1871579151
Name:TAPPER-GARDZINA, YVONNE BIRGITTA (MS, RDN)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:BIRGITTA
Last Name:TAPPER-GARDZINA
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CLOUD WAY
Mailing Address - Street 2:
Mailing Address - City:CLANCY
Mailing Address - State:MT
Mailing Address - Zip Code:59634-9663
Mailing Address - Country:US
Mailing Address - Phone:406-465-6245
Mailing Address - Fax:406-447-2703
Practice Address - Street 1:2475 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4928
Practice Address - Country:US
Practice Address - Phone:406-444-2386
Practice Address - Fax:406-447-2703
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-455133V00000X
MT531133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered