Healthcare Provider Details

I. General information

NPI: 1902714769
Provider Name (Legal Business Name): ALEX NUTRITION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 E ROOSEVELT AVE
WAKE FOREST NC
27587-2734
US

IV. Provider business mailing address

112 E ROOSEVELT AVE
WAKE FOREST NC
27587-2734
US

V. Phone/Fax

Practice location:
  • Phone: 919-521-8290
  • Fax:
Mailing address:
  • Phone: 919-521-8290
  • 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: MS. JENNY SHARPLESS
Title or Position: OWNER
Credential: LDN, RDN
Phone: 919-344-5228