Provider Demographics
NPI:1295158822
Name:NATHAN, ROMY KNOBLACH (MPH, RD)
Entity type:Individual
Prefix:
First Name:ROMY
Middle Name:KNOBLACH
Last Name:NATHAN
Suffix:
Gender:F
Credentials:MPH, RD
Other - Prefix:
Other - First Name:ROMY
Other - Middle Name:KNOBLACH GUNTER
Other - Last Name:NATHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPH, RD
Mailing Address - Street 1:1252 COBBLE POND WAY
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-6603
Mailing Address - Country:US
Mailing Address - Phone:703-919-7574
Mailing Address - Fax:
Practice Address - Street 1:1252 COBBLE POND WAY
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-6603
Practice Address - Country:US
Practice Address - Phone:703-919-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered