Provider Demographics
NPI:1417361155
Name:NEWMAN, ANNELIES (RDN)
Entity Type:Individual
Prefix:
First Name:ANNELIES
Middle Name:
Last Name:NEWMAN
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 1:1240 E 100 S STE 121
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-3079
Mailing Address - Country:US
Mailing Address - Phone:435-705-9436
Mailing Address - Fax:
Practice Address - Street 1:1240 E 100 S STE 121
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-3079
Practice Address - Country:US
Practice Address - Phone:435-705-9436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8169019-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered