Individual
JACQUELINE LYNN BERTELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, LMNT
Contact information
Practice address
8111 DODGE ST STE 332, OMAHA, NE 68114-4119
(402) 354-5947
(403) 354-5651
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
00248
IA
133V00000X
Registered Dietitian
Primary
345
NE
133V00000X
Registered Dietitian
R011922
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00248
IOWA DIETETIC LICENSE
IA
01
—
345
NEBRASKA DIETETIC LICENSE
NE
01
—
R011922
AMERICAN DIETETIC ASSOC
IA
Enumeration date
03/14/2007
Last updated
07/21/2022
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