Provider Demographics
NPI:1558040691
Name:CLAIRMONT, ANN (RD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:CLAIRMONT
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 1:1055 HOWELL MILL RD NW STE 8082
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-5557
Mailing Address - Country:US
Mailing Address - Phone:904-322-3065
Mailing Address - Fax:
Practice Address - Street 1:130 ELYSIAN WAY NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1023
Practice Address - Country:US
Practice Address - Phone:904-322-3065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD005000133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered