Healthcare Provider Details

I. General information

NPI: 1841832904
Provider Name (Legal Business Name): ANNA TRAN RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE # MOT7
ATLANTA GA
30308-2247
US

IV. Provider business mailing address

550 PEACHTREE ST NE # MOT7
ATLANTA GA
30308-2247
US

V. Phone/Fax

Practice location:
  • Phone: 404-686-1414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD005403
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: