Healthcare Provider Details

I. General information

NPI: 1457039257
Provider Name (Legal Business Name): KIDNEY FRIENDLY DIETITIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 BROADWAY ST STE 201
ASHEVILLE NC
28801-7900
US

IV. Provider business mailing address

81 BROADWAY ST STE 201
ASHEVILLE NC
28801-7900
US

V. Phone/Fax

Practice location:
  • Phone: 828-243-0302
  • Fax:
Mailing address:
  • Phone: 828-243-0302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: EMILY ROSE WHEELER
Title or Position: OWNER, REGISTERED DIETITIAN
Credential: RD, CSR, LDN
Phone: 828-243-0302