Healthcare Provider Details

I. General information

NPI: 1992233639
Provider Name (Legal Business Name): TONI ANN APADULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 05/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BLUE RIDGE RD
RALEIGH NC
27612-4650
US

IV. Provider business mailing address

302 OTMOOR LN
CARY NC
27519-8368
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 TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL001106
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: