Healthcare Provider Details

I. General information

NPI: 1235816703
Provider Name (Legal Business Name): HANNAH BALL NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 ELMFORD RD
ROCHESTER NY
14606-4338
US

IV. Provider business mailing address

78 ELMFORD RD
ROCHESTER NY
14606-4338
US

V. Phone/Fax

Practice location:
  • Phone: 585-563-2544
  • Fax:
Mailing address:
  • Phone: 585-563-2544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MRS. HANNAH ELIZABETH BALL
Title or Position: REGISTERED DIETITIAN NUTRITIONIST
Credential: RDN, CDN
Phone: 585-563-2544