is a Dietitian, Registered in Lillington, North Carolina. practices all healthcare services and medical treatments related to Dietitian, Registered. The NPI Number for is 1215048459. The last update date is .
's current location address is 307 W Cornelius Harnett Blvd, Lillington, North Carolina. You can contact this provider via phone number 9108937550 and fax number 9108144060. The mailing address for is 307 W Cornelius Harnett Blvd, Lillington, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 307 W Cornelius Harnett Blvd, Lillington, North Carolina |
| Phone Number | 9108937550 |
| Fax Number | 9108144060 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1215048459 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 307 W Cornelius Harnett Blvd |
|---|---|
| City | Lillington |
| State | North Carolina (NC) |
| Post Code | 275469335 |
| Phone Number | 9108937550 |
| Fax Number | 9108144060 |
Provider's Primary Taxonomy Detail
| Speciality | Dietitian, Registered |
|---|---|
| Taxonomy | 133V00000X |
| Licence No | L003479 |
|
Definition: A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 34D0864770 | NC | CLIA | |
| NC3404456 | NC | -- | |
| 155383938 | NC | TRICARE | |
| 7212 | NC | BCBS | |
| 183296 | NC | MEDCOST |
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