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NPI Code Detail

MEDICARE: VICTORIA ANN LEVESQUE RD

MEDICARE: VICTORIA ANN LEVESQUE RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian
2133V00000XRegistered DietitianL003343NC

General Provider Information

NPI Number : 1588185094
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA ANN LEVESQUE RD
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 704-377-3900
Fax Number :
Provider Business Practice Location Address
First Line : 125 QUEENS RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-3278
Country : US
Telephone Number : 980-302-6450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2017
Last Update Date : 12/09/2025

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Directions to “ VICTORIA ANN LEVESQUE RD” Practice Location

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