Doctor Name: | TRACY CONDER |
NPI Number: | 1386994382 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, CSSD |
License Number: | 835002 |
Business Practice Address: | 77 Nealy Avenue 633d Medical Group Joint Base Langley-eustis, VA - 236652040 |
Business Phone Number: | 7572257630 |
Business Fax Number: | |
Mailing Address: | 77 Nealy Avenue, 633d Medical Group JOINT BASE LANGLEY-EUSTIS |
State: | VA |
Postal Code: | 236652040 |
Phone Number: | 7572257630 |
Fax Number: | |
NPI Enumeration Date: | 09/17/2012 |
NPI Last Update Date: | 09/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 835002 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |