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General NPI Number Information
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NPI Number | 1427883354
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Entity Type | Individual
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Provider Name | SYDNEY DANIELLE KEANE RDN
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Gender | Female
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Dates
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Enumeration Date | 09/02/2024
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Last Update Date | 09/02/2024
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Provider Practice Location Address
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Address Line | 1215 LEE ST
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22908-0816
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Country | US
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Telephone | 540-688-5937
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Fax |
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Provider Business Mailing Address
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Address Line | 257 WINDIGROVE DR APT 1709
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City | WAYNESBORO
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State | VA
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Zip | 22980-3233
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Country | US
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Telephone | 540-645-8054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number |
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License Number State |
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