Provider Demographics
NPI:1952545667
Name:WEBER, ANA YVETTE (RD, CSP, LD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:YVETTE
Last Name:WEBER
Suffix:
Gender:F
Credentials:RD, CSP, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-0000
Mailing Address - Country:US
Mailing Address - Phone:49637-186-6333
Mailing Address - Fax:
Practice Address - Street 1:CMR 402 BOX 0
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-9998
Practice Address - Country:US
Practice Address - Phone:49637-186-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR986133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
940173OtherAMERICAN DIETETIC ASSOCIATION REGISTRATION