Healthcare Provider Details

I. General information

NPI: 1306869367
Provider Name (Legal Business Name): ROSE A OAKLEY-LANGLEY RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSE A OAKLEY

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 SW CARY PKWY SUITE 200
CARY NC
27511-6224
US

IV. Provider business mailing address

1515 SW CARY PKWY SUITE 200
CARY NC
27511-6224
US

V. Phone/Fax

Practice location:
  • Phone: 919-387-3200
  • Fax: 919-387-3201
Mailing address:
  • Phone: 919-387-3200
  • Fax: 919-387-3201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberL000147
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberL000147
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL000147
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: