Healthcare Provider Details

I. General information

NPI: 1518482322
Provider Name (Legal Business Name): NATALIE ROBERTS MOKARI RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S KINGS DR STE JJ
CHARLOTTE NC
28204-3088
US

IV. Provider business mailing address

601 S KINGS DR STE JJ
CHARLOTTE NC
28204-3088
US

V. Phone/Fax

Practice location:
  • Phone: 704-473-9021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL004927
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: