Healthcare Provider Details

I. General information

NPI: 1407045107
Provider Name (Legal Business Name): DIANE LYNNETTE DANCHI L.D.N, R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. DIANE LYNNETTE CARROLL

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 09/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 SW CARY PARKWAY SUITE 150
CARY NC
27511-6225
US

IV. Provider business mailing address

211 FRIDAY CENTER DR SUITE 2091, ROOM 2094 HEDRICK BUILDING
CHAPEL HILL NC
27517-9499
US

V. Phone/Fax

Practice location:
  • Phone: 919-387-0080
  • Fax: 919-387-3908
Mailing address:
  • Phone: 984-974-1191
  • Fax: 984-974-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberL000710
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number000710
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL000710
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: