Provider Demographics
NPI:1912027392
Name:CREASEY, LINDA LEE (RD)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LEE
Last Name:CREASEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEE
Other - Last Name:SWEIGART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:PO BOX 758997
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-0001
Mailing Address - Country:US
Mailing Address - Phone:804-828-2841
Mailing Address - Fax:804-628-0783
Practice Address - Street 1:1250 E. MARSHALL STREET
Practice Address - Street 2:CLINICAL NUTRITION
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0924
Practice Address - Country:US
Practice Address - Phone:804-828-0970
Practice Address - Fax:804-628-0921
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA710000042Medicare ID - Type UnspecifiedC06293