Provider Demographics
NPI:1518332204
Name:HASEMANN, ANGELA JEAN (RDN, CSP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:JEAN
Last Name:HASEMANN
Suffix:
Gender:F
Credentials:RDN, CSP
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:HASEMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDN, CSP
Mailing Address - Street 1:1617 TRAILRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4024
Mailing Address - Country:US
Mailing Address - Phone:434-982-2522
Mailing Address - Fax:
Practice Address - Street 1:1617 TRAILRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4024
Practice Address - Country:US
Practice Address - Phone:434-982-2522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-06
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric