Provider Demographics
NPI:1982467015
Name:THE VIRTUAL REGISTERED DIETITIAN
Entity Type:Organization
Organization Name:THE VIRTUAL REGISTERED DIETITIAN
Other - Org Name:AR NUTRITION - THE VIRTUAL RD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABENA
Authorized Official - Middle Name:
Authorized Official - Last Name:RETEMIAH
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:231-769-0277
Mailing Address - Street 1:7103 ANNABELL DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-8479
Mailing Address - Country:US
Mailing Address - Phone:231-769-0277
Mailing Address - Fax:
Practice Address - Street 1:1500 E. SHERMAN BLVD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444
Practice Address - Country:US
Practice Address - Phone:231-769-0277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty