Provider Demographics
NPI:1699071621
Name:TUTWILER, CHERYL
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:TUTWILER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HEALTH CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2448
Mailing Address - Country:US
Mailing Address - Phone:540-458-3233
Mailing Address - Fax:
Practice Address - Street 1:1 HEALTH CIR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2448
Practice Address - Country:US
Practice Address - Phone:540-458-3233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA876098133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered