Provider Demographics
NPI:1740614213
Name:HOTTENSTEIN, ANNETTE JEANINE (MS, RD)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:JEANINE
Last Name:HOTTENSTEIN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16003 YORK RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS GLENCOE
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9380
Mailing Address - Country:US
Mailing Address - Phone:410-343-9209
Mailing Address - Fax:
Practice Address - Street 1:17010 YORK RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:MD
Practice Address - Zip Code:21120-9719
Practice Address - Country:US
Practice Address - Phone:410-215-7549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3376133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered