Healthcare Provider Details

I. General information

NPI: 1013386473
Provider Name (Legal Business Name): NADEEN RISI R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NADEEN ELHADDAD

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 MACON POND RD STE 310
RALEIGH NC
27607-6320
US

IV. Provider business mailing address

1831 DEVONRIDGE DR
FUQUAY VARINA NC
27526-7655
US

V. Phone/Fax

Practice location:
  • Phone: 919-205-2505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL004713
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: