Provider Demographics
NPI:1225529662
Name:HENRY, DANA NICHOLE (RDN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:NICHOLE
Last Name:HENRY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 800673
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0673
Mailing Address - Country:US
Mailing Address - Phone:434-982-4925
Mailing Address - Fax:
Practice Address - Street 1:132 GLEN CIR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:VA
Practice Address - Zip Code:22974-3031
Practice Address - Country:US
Practice Address - Phone:434-982-4925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered