Healthcare Provider Details

I. General information

NPI: 1811011026
Provider Name (Legal Business Name): BONNIE PRZELOMSKI M.S., R.D., L.D.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 STORAGE RD
ROCKY MOUNT NC
27804-8561
US

IV. Provider business mailing address

2805 CARRINGTON RD
ROCKY MOUNT NC
27804-2111
US

V. Phone/Fax

Practice location:
  • Phone: 252-443-0318
  • Fax: 252-443-5079
Mailing address:
  • Phone: 252-451-1827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License NumberL000052
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: