Provider Demographics
NPI:1902143985
Name:GREGG, NATARCHA RENEE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:NATARCHA
Middle Name:RENEE
Last Name:GREGG
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 1:4560 SOUTH BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1160
Mailing Address - Country:US
Mailing Address - Phone:757-623-0005
Mailing Address - Fax:757-548-1129
Practice Address - Street 1:420 N CENTER DR
Practice Address - Street 2:BLDG 11 SUITE 128
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4007
Practice Address - Country:US
Practice Address - Phone:757-623-0005
Practice Address - Fax:757-548-1129
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal