MEDICARE: TRACY HATFIELD YODA MS, RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1558574707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY HATFIELD YODA MS, RD

Provider Business Mailing Address
First Line	:	100 EMANCIPATION DR
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23667-0001
Country	:	US
Telephone Number	:	757-722-9961
Fax Number	:

Provider Business Practice Location Address
First Line	:	6333 CENTER DR BLDG 16
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-4126
Country	:	US
Telephone Number	:	757-252-9500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	09/17/2024

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