Provider Demographics
NPI:1831086032
Name:VAN CAMP, ALLISON ELAINE (RD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ELAINE
Last Name:VAN CAMP
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9380 OLD SOUTHWICK PASS
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5566
Mailing Address - Country:US
Mailing Address - Phone:404-610-1805
Mailing Address - Fax:
Practice Address - Street 1:116 E HOWARD AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3345
Practice Address - Country:US
Practice Address - Phone:678-568-4717
Practice Address - Fax:678-951-0508
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered