Provider Demographics
NPI:1164985982
Name:MONICO, ERIN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MONICO
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 HUNTON LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:VA
Mailing Address - Zip Code:22503-3584
Mailing Address - Country:US
Mailing Address - Phone:703-407-6242
Mailing Address - Fax:
Practice Address - Street 1:1110 HUNTON LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:VA
Practice Address - Zip Code:22503-3584
Practice Address - Country:US
Practice Address - Phone:703-407-6242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005392133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCL005392OtherNORTH CAROLINA BOARD OF DIETETICS/NUTRITION