Provider Demographics
NPI:1437031119
Name:KEENAN, DANIELLA (RDN, CNSC)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:
Last Name:KEENAN
Suffix:
Gender:F
Credentials:RDN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5513 STUBBEN CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-1871
Mailing Address - Country:US
Mailing Address - Phone:302-379-8169
Mailing Address - Fax:
Practice Address - Street 1:5513 STUBBEN CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-1871
Practice Address - Country:US
Practice Address - Phone:302-379-8169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD006525133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered