Provider Demographics
NPI:1457068835
Name:EPEAGBA, PRECIOUS CHIAMKA (MS, RDN, LDN, CHES)
Entity Type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:CHIAMKA
Last Name:EPEAGBA
Suffix:
Gender:F
Credentials:MS, RDN, LDN, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1722
Mailing Address - Country:US
Mailing Address - Phone:334-294-3316
Mailing Address - Fax:
Practice Address - Street 1:613 BESSEMER SUPER HWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35228-3012
Practice Address - Country:US
Practice Address - Phone:800-881-5101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL86169861133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered