Healthcare Provider Details

I. General information

NPI: 1851932297
Provider Name (Legal Business Name): KAREN MARY MANSCHOT MS, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 WASHINGTON ST
RALEIGH NC
27605-1258
US

IV. Provider business mailing address

1042 WASHINGTON ST
RALEIGH NC
27605-1258
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: