Provider Demographics
NPI:1548735335
Name:STAPLES, HANNAH (RD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:STAPLES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 GLENDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49004-1715
Mailing Address - Country:US
Mailing Address - Phone:616-826-0226
Mailing Address - Fax:
Practice Address - Street 1:2044 GLENDALE BLVD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49004-1715
Practice Address - Country:US
Practice Address - Phone:616-826-0226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered