Provider Demographics
NPI:1821762436
Name:HACKMAN, JULIA LANETTE (RDN)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:LANETTE
Last Name:HACKMAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 W 38TH ST APT 324
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-2655
Mailing Address - Country:US
Mailing Address - Phone:435-773-1197
Mailing Address - Fax:
Practice Address - Street 1:1055 W 38TH ST APT 324
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2655
Practice Address - Country:US
Practice Address - Phone:435-773-1197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered