Provider Demographics
NPI:1336759919
Name:MOOREFIELD, EMILY KANE (RD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:KANE
Last Name:MOOREFIELD
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 1:1904 CALVARY CIR APT 407
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8466
Mailing Address - Country:US
Mailing Address - Phone:757-641-1032
Mailing Address - Fax:
Practice Address - Street 1:709A W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4570
Practice Address - Country:US
Practice Address - Phone:434-326-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA86152219133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered