Healthcare Provider Details

I. General information

NPI: 1497281117
Provider Name (Legal Business Name): ANNA METZ LUTZ MPH, RD, LDN, CEDRD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 05/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BLUE RIDGE RD SUITE 140
RALEIGH NC
27612-4650
US

IV. Provider business mailing address

4000 BLUE RIDGE RD SUITE 140
RALEIGH NC
27612-4650
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-4500
  • Fax: 919-781-4504
Mailing address:
  • Phone: 919-781-4500
  • Fax: 919-781-4504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL002702
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: