Provider Demographics
NPI:1285254110
Name:MYERS, EMILY ANNE (PHD, RDN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:MYERS
Suffix:
Gender:F
Credentials:PHD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 PIEDMONT ST
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-4925
Mailing Address - Country:US
Mailing Address - Phone:540-230-4023
Mailing Address - Fax:
Practice Address - Street 1:602 PIEDMONT ST
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-4925
Practice Address - Country:US
Practice Address - Phone:540-230-4023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA86063761133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered