Provider Demographics
NPI:1841066057
Name:LEBARRON, HALEY WHITEMAN (RDN)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:WHITEMAN
Last Name:LEBARRON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MISS
Other - First Name:HALEY
Other - Middle Name:MAREE
Other - Last Name:WHITEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:600 TRACY WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-1262
Mailing Address - Country:US
Mailing Address - Phone:304-388-4965
Mailing Address - Fax:
Practice Address - Street 1:600 TRACY WAY STE 2
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-1262
Practice Address - Country:US
Practice Address - Phone:304-388-4965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1262133VN1004X, 133VN1201X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management