MS. MARY ANN B FLORESTAN (NPI# 1477610095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477610095 |
| Entity Type | Individual |
| Full Name | MS. MARY ANN B FLORESTAN |
| Credential | RD, LD |
| Practice Address |
4757 Canton Rd Suite 110 Marietta GA 30066-3234 |
| Mailing Address |
4757 Canton Rd, Ne Suite 110 Marietta GA 30066-3234 |
| Practice Telephone | 7705170105 |
| Practice Fax Number | 7705170105 |
| Mailing Telephone | 7705170105 |
| Mailing Fax Number | 7705170105 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 001660 | GA | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | WELLCARE | 332644 | 01 |
| GA | AMERIGROUP | 10040673 | 01 |
| Street Address |
4757 CANTON RD SUITE 110 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30066-3234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598253684 | Comfort Community Center, LLC | Skilled Nursing Facility | 2440 Sandy Plains Road, Blvd 21, Suite 100, Marietta, GA 30066 | 2018-04-25 |
| 1538681994 | Passionate Care | In Home Supportive Care | 1110 Renfro Ln., Marietta, GA 30066 | 2017-07-07 |
| 1437510443 | Steven Caras | Internal Medicine | 2682 Bonaire Terrace, Marietta, GA 30066 | 2016-03-18 |
| 1275918781 | Latifat Bolajoko Asemota | Nurse Practitioner | 410 Nottingham Dr, Marietta, GA 30066 | 2015-07-26 |
| 1497094205 | Changing Phases Behavioral Support, Inc | Internal Medicine | 3655 Canton Rd Ste 201, Marietta, GA 30066 | 2013-02-14 |
| 1659618916 | Alison Nicole Sims | Occupational Therapist | 2465 Canopy Drive, Marietta, GA 30066 | 2013-01-07 |
| 1790044907 | Antoine Jose Davenport | Massage Therapist | 4686 Jamerson Creek Dr, Marietta, GA 30066 | 2012-05-08 |
| 1174898548 | Angel Elizabeth Nofziger | Nurse Practitioner | 3750 Palladian Village Dr Ste 300, Marietta, GA 30066 | 2012-03-18 |
| 1912298019 | Nancy Jean Slack | Pharmacist | 2833 Canton Road, Marietta, GA 30066 | 2011-04-22 |
| 1336456078 | Mario B Miller Sr. | Chiropractor | 50 Barrett Parkway, Suite 3005#126, Marietta, GA 30066 | 2010-09-01 |
| Find all providers in zip 30066 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020735 | Kelli Rose Yates | Dietitian, Registered | 4472 Chimney Springs Ct, Marietta, GA 30062-5730 | 2020-07-08 |
| 1801363890 | Hiba Hamadeh | Dietitian, Registered | 972 Bridgegate Dr Ne, Marietta, GA 30068-2207 | 2018-10-27 |
| 1073974283 | Janice Wiley | Dietitian, Registered | 1733 Rifle Rdg Sw, Marietta, GA 30064-4878 | 2016-03-15 |
| 1326411174 | Elizabeth M. Young | Dietitian, Registered | 4678 Cherry Way Se, Marietta, GA 30067-4614 | 2015-11-02 |
| 1528444593 | Daisy Seremba | Dietitian, Registered | 3082 Bunker Hill Rd, Marietta, GA 30062-5418 | 2015-07-31 |
| 1598018764 | Nutrikiss Inc | Dietitian, Registered | 2155 Camberley Pl, Marietta, GA 30062-1894 | 2012-10-24 |
| 1629348727 | Crystal Marie Shores | Dietitian, Registered | 5150 Davidson Road, Marietta, GA 30068 | 2012-01-05 |
| 1275812802 | Elizabeth Thurston | Dietitian, Registered | 813 Burning Tree Ct Se, Marietta, GA 30067-4719 | 2011-08-13 |
| 1538364146 | Shelia Malinda Jones | Dietitian, Registered | 1458 Barnacle St, Marietta, GA 30066-1802 | 2007-06-15 |
| 1750321766 | Angela Renee Pinkerton | Dietitian, Registered | 938 Lancaster St, Marietta, OH 45750-9497 | 2006-06-07 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.