Provider Demographics
NPI:1770224040
Name:SUTA, EMINA (MS RD RDN INFCP)
Entity type:Individual
Prefix:MRS
First Name:EMINA
Middle Name:
Last Name:SUTA
Suffix:
Gender:F
Credentials:MS RD RDN INFCP
Other - Prefix:
Other - First Name:EMINA
Other - Middle Name:
Other - Last Name:HADZIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:22959 FANSHAW SQ
Mailing Address - Street 2:
Mailing Address - City:BRAMBLETON
Mailing Address - State:VA
Mailing Address - Zip Code:20148-5673
Mailing Address - Country:US
Mailing Address - Phone:614-806-7550
Mailing Address - Fax:
Practice Address - Street 1:22959 FANSHAW SQ
Practice Address - Street 2:
Practice Address - City:BRAMBLETON
Practice Address - State:VA
Practice Address - Zip Code:20148-5673
Practice Address - Country:US
Practice Address - Phone:614-806-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-02
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1067549133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0000OtherINSURANCES
VA000000OtherINSURANCES