Healthcare Provider Details

I. General information

NPI: 1710236534
Provider Name (Legal Business Name): DAWN BELCH FARMER MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 ROANOKE AVE
ELIZABETH CITY NC
27909-5643
US

IV. Provider business mailing address

711 ROANOKE AVE
ELIZABETH CITY NC
27909-5643
US

V. Phone/Fax

Practice location:
  • Phone: 252-338-4370
  • Fax: 252-337-7911
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL002832
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: