Healthcare Provider Details

I. General information

NPI: 1679480578
Provider Name (Legal Business Name): HOLLIE ZAMMIT RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 WYLDEROSE CMNS STE 200
MIDLOTHIAN VA
23113-6918
US

IV. Provider business mailing address

250 WYLDEROSE CMNS STE 200
MIDLOTHIAN VA
23113-6918
US

V. Phone/Fax

Practice location:
  • Phone: 804-592-0095
  • Fax: 804-655-6183
Mailing address:
  • Phone: 804-592-0095
  • Fax: 804-655-6183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number964648
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: