Doctor Name: | CHARLENE ELLESTAD |
NPI Number: | 1467725960 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1900 Electric Rd Salem, VA - 241537474 |
Business Phone Number: | 5407764567 |
Business Fax Number: | |
Mailing Address: | 1900 Electric Rd, SALEM |
State: | VA |
Postal Code: | 241537474 |
Phone Number: | 5407764567 |
Fax Number: | |
NPI Enumeration Date: | 02/14/2012 |
NPI Last Update Date: | 02/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |