Healthcare Provider Details

I. General information

NPI: 1740104942
Provider Name (Legal Business Name): LEAH KAY JAMISON MPH, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 CAPPIE DR APT 408
CARY NC
27519-7270
US

IV. Provider business mailing address

236 HIGH RIDGE LN
PITTSBORO NC
27312-6733
US

V. Phone/Fax

Practice location:
  • Phone: 919-791-7667
  • Fax:
Mailing address:
  • Phone: 919-791-7667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL010198
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: