Provider Demographics
NPI:1780993246
Name:WEBB, BETH ANN (RD)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:WEBB
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-2225
Mailing Address - Country:US
Mailing Address - Phone:248-608-0826
Mailing Address - Fax:248-608-0826
Practice Address - Street 1:484 CYPRESS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-2225
Practice Address - Country:US
Practice Address - Phone:248-608-0826
Practice Address - Fax:248-608-0826
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL852886133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal