Provider Demographics
NPI:1114752334
Name:PETREE, AMBER (RD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PETREE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 CAMPUS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2800
Mailing Address - Country:US
Mailing Address - Phone:540-536-3041
Mailing Address - Fax:
Practice Address - Street 1:401 CAMPUS BLVD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2800
Practice Address - Country:US
Practice Address - Phone:540-536-3041
Practice Address - Fax:540-536-3045
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered