Provider Demographics
NPI:1487345419
Name:BARBEROUSSE, ABIGAIL KENNEDY (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:KENNEDY
Last Name:BARBEROUSSE
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 7 LKS W
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9352
Mailing Address - Country:US
Mailing Address - Phone:412-215-5760
Mailing Address - Fax:
Practice Address - Street 1:166 7 LKS W
Practice Address - Street 2:178 JAMES DRIVE
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376
Practice Address - Country:US
Practice Address - Phone:412-215-5760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004948133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered