Provider Demographics
NPI:1346605417
Name:DIGIOVANNI, SASHA COEFIELD (RD)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:COEFIELD
Last Name:DIGIOVANNI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SASHA
Other - Middle Name:MARIE
Other - Last Name:COEFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1705 GARDNER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-8873
Mailing Address - Country:US
Mailing Address - Phone:910-343-5300
Mailing Address - Fax:
Practice Address - Street 1:1705 GARDNER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405
Practice Address - Country:US
Practice Address - Phone:910-343-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004772133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered