1659339026 NPI number — MS. HEATHER ANGELA NELSON MS, RD

Table of content: MS. HEATHER ANGELA NELSON MS, RD (NPI 1659339026)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659339026 NPI number — MS. HEATHER ANGELA NELSON MS, RD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NELSON
Provider First Name:
HEATHER
Provider Middle Name:
ANGELA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, RD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659339026
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
LANDSTUHL REGIONAL MEDICAL CENTER
Provider Second Line Business Mailing Address:
ATTN: MCEUL-DCCS (CREDENTIALS), CMR 402
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09180
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
011496371868839
Provider Business Mailing Address Fax Number:
011496371866133

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LANDSTUHL REGIONAL MEDICAL CENTER
Provider Second Line Business Practice Location Address:
NUTRITION CARE DIVISION
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09180
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
011496371866639
Provider Business Practice Location Address Fax Number:
011496371866192
Provider Enumeration Date:
05/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  814633 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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