Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Phs Providence Diabetes and Nutrition Center

Organization Registered Dietitian · NPI 1881859817

Phs Providence Diabetes and Nutrition Center is a Registered Dietitian in Washington, District of Columbia. Licensed in District of Columbia. Registered with an NPI since 2008.

Licensed in
DC
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

1160 Varnum St NE Depaul 110
Washington, DC 20017-2107
Phone: (202) 854-7123
Fax: (202) 854-4854
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence HFD01-0212 (DC)
Surgery Physician Taxonomy 208600000X · Licence HFD01-0212 (DC)

Record details

NPI number1881859817
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Hospital
Authorized official Beau Higginbotham — Vice President/Coo · (410) 368-3162
Other names Phs Joslin Diabetes Center Dp110
NPI enumeratedJuly 18, 2008
Last updated in NPPESOctober 9, 2017
Mailing address1160 Varnum St Ne, St. Catherine'S Hall, Room 102, Washington, DC 20017-2107

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