Provider Demographics
NPI:1730622051
Name:FLETCHER, ARNETTA RENEE (PHD, RDN, LDN)
Entity type:Individual
Prefix:DR
First Name:ARNETTA
Middle Name:RENEE
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:PHD, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4036 PURPLE FLORA BND
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-5685
Mailing Address - Country:US
Mailing Address - Phone:434-465-2868
Mailing Address - Fax:
Practice Address - Street 1:4036 PURPLE FLORA BND
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-5685
Practice Address - Country:US
Practice Address - Phone:434-465-2868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1158133V00000X
MDDX4101133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD47-3537171OtherIRS EIN