Provider Demographics
NPI:1235143371
Name:HERMAN, ASHLEIGH M (RD, LD)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:M
Last Name:HERMAN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JEFFERSON BARRACKS RD
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-4181
Mailing Address - Country:US
Mailing Address - Phone:314-652-4100
Mailing Address - Fax:314-845-5023
Practice Address - Street 1:1 JEFFERSON BARRACKS RD
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-4181
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:314-845-5023
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006005734133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered