Healthcare Provider Details

I. General information

NPI: 1760469282
Provider Name (Legal Business Name): ALESA MCDOWELL EANES RD,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 RIDGE RD
ROXBORO NC
27573-4629
US

IV. Provider business mailing address

505 CRABTREE CREEK RD
HILLSBOROUGH NC
27278-7154
US

V. Phone/Fax

Practice location:
  • Phone: 336-503-5718
  • Fax:
Mailing address:
  • Phone: 919-732-2548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL002096
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: