Provider Demographics
NPI:1205021441
Name:HYLTON, VICKIE ROSALIE (RD)
Entity Type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:ROSALIE
Last Name:HYLTON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 DRY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-6202
Mailing Address - Country:US
Mailing Address - Phone:540-731-2742
Mailing Address - Fax:
Practice Address - Street 1:2900 TYLER RD
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-5041
Practice Address - Country:US
Practice Address - Phone:540-731-2742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered