Provider Demographics
NPI:1316522212
Name:REDNICK, DANIELLE PAIGE (RD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:PAIGE
Last Name:REDNICK
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 1:7 N 8TH ST APT 825
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-3323
Mailing Address - Country:US
Mailing Address - Phone:240-483-2129
Mailing Address - Fax:
Practice Address - Street 1:1200 E BROAD ST FL 17
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5025
Practice Address - Country:US
Practice Address - Phone:804-628-0921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered