Healthcare Provider Details

I. General information

NPI: 1487251708
Provider Name (Legal Business Name): WHOLE HEALTH PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2020
Last Update Date: 04/13/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 9TH ST STE 120110
DURHAM NC
27705-4149
US

IV. Provider business mailing address

811 9TH ST STE 120110
DURHAM NC
27705-4149
US

V. Phone/Fax

Practice location:
  • Phone: 919-285-0855
  • Fax:
Mailing address:
  • Phone: 919-285-0855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNI GROVER
Title or Position: OWNER
Credential: MS RD LDN
Phone: 919-360-1236