Provider Demographics
NPI:1679709927
Name:MCNABB, ANGELA B (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:B
Last Name:MCNABB
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 HAZELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:AL
Mailing Address - Zip Code:35750-8819
Mailing Address - Country:US
Mailing Address - Phone:256-828-8223
Mailing Address - Fax:
Practice Address - Street 1:162 HAZELWOOD DR
Practice Address - Street 2:
Practice Address - City:HAZEL GREEN
Practice Address - State:AL
Practice Address - Zip Code:35750-8819
Practice Address - Country:US
Practice Address - Phone:256-828-8223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1651133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered