Provider Demographics
NPI:1790928158
Name:WHELAN, ANN M (RD, LD, CDE)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:WHELAN
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2365 SALEM AVE
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1829
Mailing Address - Country:US
Mailing Address - Phone:614-975-8223
Mailing Address - Fax:
Practice Address - Street 1:2365 SALEM AVE
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-1829
Practice Address - Country:US
Practice Address - Phone:614-975-8223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3076133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered