Provider Demographics
NPI:1295844793
Name:SABULA, ANN MARIE CHALMERS (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:ANN MARIE
Middle Name:CHALMERS
Last Name:SABULA
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CROWN AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-1434
Mailing Address - Country:US
Mailing Address - Phone:401-289-0549
Mailing Address - Fax:401-289-0549
Practice Address - Street 1:610 WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-2427
Practice Address - Country:US
Practice Address - Phone:401-289-0549
Practice Address - Fax:401-289-0549
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00017133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI26598-4OtherBLUE CROSS BLUE SHIELD
RI28123OtherNEIGHBORHOOD HEALTH
RI050500640OtherUNITED HEALTHCARE
RI410571OtherBLUE CHIP
RI050500640OtherUNITED HEALTHCARE