Madonna Renee Merchant
Dietitian, Registered in Norfolk, VA. Individual provider (NPI-1).
NPI number1336769710
StatusActive
Last updated in NPPESApr 25, 2020
Details
- NPI
- 1336769710
- Entity type
- Individual (NPI-1)
- Name
- Madonna Renee Merchant
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 25, 2020
- Certification date
- Apr 25, 2020
- Last updated
- Apr 25, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 86007687 | VA | Yes |
Practice location
1453 Westover AveNorfolk, VA 23507-1027
Phone 757-403-0462
Mailing address
1453 Westover AveNorfolk, VA 23507-1027
Phone 757-403-0462
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