Provider Demographics
NPI:1720796097
Name:CROTEAU, VANESSA LYNN (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LYNN
Last Name:CROTEAU
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03833-6803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29 LAFAYETTE RD STE A4
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-2437
Practice Address - Country:US
Practice Address - Phone:603-531-1805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1158133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered