Provider Demographics
NPI:1639991128
Name:SMYTH, CHELSEA N (RD)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:N
Last Name:SMYTH
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 1:1231 WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-3744
Mailing Address - Country:US
Mailing Address - Phone:804-437-2280
Mailing Address - Fax:
Practice Address - Street 1:9000 STONY POINT PARKWAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235
Practice Address - Country:US
Practice Address - Phone:804-560-8950
Practice Address - Fax:804-560-7343
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1084510133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered