Healthcare Provider Details

I. General information

NPI: 1982202982
Provider Name (Legal Business Name): KATHERINE BROWN RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 LAKE BOONE TRL
RALEIGH NC
27607-6521
US

IV. Provider business mailing address

5221 PARAMOUNT PKWY STE 440
MORRISVILLE NC
27560-5491
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-1303
  • Fax: 919-784-1397
Mailing address:
  • Phone: 984-974-1191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberL008512
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86093781
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: