Provider Demographics
NPI:1457624090
Name:ZIBDEH, NOUR M (RD)
Entity Type:Individual
Prefix:
First Name:NOUR
Middle Name:M
Last Name:ZIBDEH
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 1:13591 BATHGATE DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-3497
Mailing Address - Country:US
Mailing Address - Phone:540-230-6953
Mailing Address - Fax:
Practice Address - Street 1:13591 BATHGATE DR
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-3497
Practice Address - Country:US
Practice Address - Phone:540-230-6953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered