Provider Demographics
NPI:1891130324
Name:CRISP, AMY (RD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CRISP
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 HOLIDAY CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-4365
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:419 HOLIDAY CT
Practice Address - Street 2:SUITE 200
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-4365
Practice Address - Country:US
Practice Address - Phone:540-316-2640
Practice Address - Fax:540-316-2641
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered