Provider Demographics
NPI:1679769079
Name:CHARLTON, ANGELA KAREN (RD, CNSD)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:KAREN
Last Name:CHARLTON
Suffix:
Gender:F
Credentials:RD, CNSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 JEFFERSON ST SW
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-2419
Mailing Address - Country:US
Mailing Address - Phone:540-981-7552
Mailing Address - Fax:
Practice Address - Street 1:2013 JEFFERSON ST SW
Practice Address - Street 2:1ST FLOOR
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-2419
Practice Address - Country:US
Practice Address - Phone:540-981-7552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered