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NPI Code Detail

MEDICARE: YOLANDA GALE PEARSON M.S., R.D., C.D.E.

MEDICARE: YOLANDA GALE PEARSON M.S., R.D., C.D.E.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10007070091OTHERVAAETNA
2283514OTHERVAMAMSI LIFE AND HEALTH

General Provider Information

NPI Number : 1346246311
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOLANDA GALE PEARSON M.S., R.D., C.D.E.
Provider Business Mailing Address
First Line : 860 OMNI BLVD
Second Line : SUITE 303
City : NEWPORT NEWS
State : VA
Zip : 23606-4430
Country : US
Telephone Number : 757-232-8769
Fax Number : 757-232-8875
Provider Business Practice Location Address
First Line : 860 OMNI BLVD
Second Line : SUITE 301C
City : NEWPORT NEWS
State : VA
Zip : 23606-4430
Country : US
Telephone Number : 757-223-9403
Fax Number : 757-327-0658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 11/27/2012

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