Lynita D Mason, RDG

Individual provider Active NPI Registered Dietitian · Ivor, VA

NPI 1720319932 · NPPES record last updated Jan 28, 2010

Key facts

NPI
1720319932
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
0402202259 (VA)
Practice address
8575 Ivor Road
Ivor, VA 23866
Phone
(757) 859-6161
Fax
(757) 859-6452
NPI assigned
Jan 28, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0402202259VAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 0402202259 VA Yes

Addresses

Primary practice location

8575 Ivor Road
Ivor, VA 23866

Mailing address

8575 Ivor Road
Ivor, VA 23866
Phone (757) 859-6161

Other providers in Ivor, VA

All providers in Ivor, VA · Registered Dietitian in Virginia

Sources for this page

Verify at the official NPI Registry.