Provider Demographics
NPI:1295585875
Name:QUESENBERRY, ALLISON HURST (RD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:HURST
Last Name:QUESENBERRY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:PAIGE
Other - Last Name:HURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3702 POPLAR KNOB RD
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-6463
Mailing Address - Country:US
Mailing Address - Phone:276-229-8462
Mailing Address - Fax:
Practice Address - Street 1:3702 POPLAR KNOB RD
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-6463
Practice Address - Country:US
Practice Address - Phone:276-229-8462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC86107987133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered