Provider Demographics
NPI:1598882680
Name:MYERS, ANGELA (RD, LDN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:KIECHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDLDN
Mailing Address - Street 1:434 KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2610
Mailing Address - Country:US
Mailing Address - Phone:610-967-3257
Mailing Address - Fax:
Practice Address - Street 1:327 CHESTNUT ST
Practice Address - Street 2:ST. LUKE'S UNIVERSITY HEALTH NETWORK WARREN CAMPUS
Practice Address - City:EAST BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-2224
Practice Address - Country:US
Practice Address - Phone:908-859-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003405133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered