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General NPI Number Information
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NPI Number | 1578596185
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF VETERAN AFFAIRS
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 312 KENMORE RD
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City | PENSACOLA
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State | FL
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Zip | 32503-7462
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Country | US
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Telephone | 850-471-7503
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Fax | 850-471-7744
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Provider Business Mailing Address
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Address Line | 7520 HELMS RD
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City | PENSACOLA
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State | FL
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Zip | 32526-8588
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Country | US
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Telephone | 850-944-4251
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Fax | 850-471-7744
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Authorized Official
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Title or Position | CLINICAL DIETITIAN SPECIALIST
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Name | MRS. TONYA LYNN CRONIER-DUDA
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Credential | RD, LD/N
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Telephone | 850-471-7503
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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 | ND4600
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License Number State | FL
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