Provider Demographics
NPI:1801657747
Name:VANHIMBERGEN, LESLIE BROWN (RD)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:BROWN
Last Name:VANHIMBERGEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1200 EAST BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0294
Mailing Address - Country:US
Mailing Address - Phone:804-828-5765
Mailing Address - Fax:
Practice Address - Street 1:1200 EAST BROAD STREET
Practice Address - Street 2:NUTRITION CLINIC 4TH FLOOR EAST WING
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0294
Practice Address - Country:US
Practice Address - Phone:804-828-0970
Practice Address - Fax:804-628-0204
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric