Provider Demographics
NPI:1225798804
Name:KATZBERG, ANGELA M (RD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:KATZBERG
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 1:130 S PROSSER AVE
Mailing Address - Street 2:
Mailing Address - City:JUNIATA
Mailing Address - State:NE
Mailing Address - Zip Code:68955-2054
Mailing Address - Country:US
Mailing Address - Phone:402-469-5643
Mailing Address - Fax:
Practice Address - Street 1:130 S PROSSER AVE
Practice Address - Street 2:
Practice Address - City:JUNIATA
Practice Address - State:NE
Practice Address - Zip Code:68955-2054
Practice Address - Country:US
Practice Address - Phone:402-469-5643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE883234133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered