Healthcare Provider Details

I. General information

NPI: 1679477129
Provider Name (Legal Business Name): MADISON PEPE RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 PINEGATE CIR APT 11
CHAPEL HILL NC
27514-2265
US

IV. Provider business mailing address

207 PINEGATE CIR APT 11
CHAPEL HILL NC
27514-2265
US

V. Phone/Fax

Practice location:
  • Phone: 336-671-0300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL010416
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: