Nutrition And Diabetes Education Center, Llc | |
12150 Annapolis Rd, Ste 104, Glenn Dale, MD 20769-9183 | |
(301) 805-8292 | |
(301) 352-0405 |
Full Name | Nutrition And Diabetes Education Center, Llc |
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Type | Facility |
Speciality | Dietitian, Registered |
Location | 12150 Annapolis Rd, Glenn Dale, Maryland |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1275866055 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | D01715 (Maryland) | Primary |
133VN1006X | Dietitian, Registered - Nutrition, Metabolic | D01715 (Maryland) | Secondary |
Provider Name | Sharon E Hawks |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1417141557 PECOS PAC ID: 8224020557 Enrollment ID: I20040330000770 |
Provider Name | Jennifer I Hall |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1609068592 PECOS PAC ID: 2163510025 Enrollment ID: I20071112000239 |
Provider Name | Natalie O Tukpah |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043647340 PECOS PAC ID: 1850516105 Enrollment ID: I20140728001535 |
Mailing Address | Practice Location Address |
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Nutrition And Diabetes Education Center, Llc 12150 Annapolis Rd., Ste. 104, Glenn Dale, MD 20769 Ph: (301) 805-8292 | Nutrition And Diabetes Education Center, Llc 12150 Annapolis Rd, Ste 104, Glenn Dale, MD 20769-9183 Ph: (301) 805-8292 |
Nutrition And Diabetes Education Center, Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 12150 Annapolis Rd, Ste 104, Glenn Dale, MD 20769 Phone: 301-805-8292 |