Healthcare Provider Details

I. General information

NPI: 1649663022
Provider Name (Legal Business Name): AMANDA HOLLIDAY MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2015
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 DAUER DR 261 ROSENAU HALL, CB #7461
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

135 DAUER DR 261 ROSENAU HALL, CB #7461
CHAPEL HILL NC
27599-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-7214
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: