Provider Demographics
NPI:1841505682
Name:TREACY, ANNA C (MPH, CHES)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:C
Last Name:TREACY
Suffix:
Gender:F
Credentials:MPH, CHES
Other - Prefix:
Other - First Name:BODY RECLAMATION
Other - Middle Name:
Other - Last Name:PROJECT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34707
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89533-4707
Mailing Address - Country:US
Mailing Address - Phone:775-750-8600
Mailing Address - Fax:
Practice Address - Street 1:421 HILL ST
Practice Address - Street 2:#1
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-1821
Practice Address - Country:US
Practice Address - Phone:775-750-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13065133NN1002X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education