Healthcare Provider Details

I. General information

NPI: 1821058769
Provider Name (Legal Business Name): MARY ANNE CABLE R.D.,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST
DURHAM NC
27705-3875
US

IV. Provider business mailing address

13128 NORWOOD RD
RALEIGH NC
27614-9132
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-6931
  • Fax: 919-416-5825
Mailing address:
  • Phone: 919-846-3565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberL000887
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberL000887
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL000887
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: