Provider Demographics
NPI:1144675703
Name:HESS, AUDREY C (MPH, RDN, LDN)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:C
Last Name:HESS
Suffix:
Gender:F
Credentials:MPH, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MONUMENT RD SUITE 202
Mailing Address - Street 2:WELLSPAN MATERNAL FETAL MEDICINE,
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403
Mailing Address - Country:US
Mailing Address - Phone:717-851-2722
Mailing Address - Fax:717-851-3127
Practice Address - Street 1:35 MONUMENT RD SUITE 202
Practice Address - Street 2:WELLSPAN MATERNAL FETAL MEDICINE
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403
Practice Address - Country:US
Practice Address - Phone:717-851-2722
Practice Address - Fax:717-851-3127
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003111133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered