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Individual

ABBY ROSE CHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDN

Contact information

Practice address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 214-2800
(928) 214-2932

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86052458

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
235726
AZ
Enumeration date
12/13/2016
Last updated
03/14/2017
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