Healthcare Provider Details

I. General information

NPI: 1962508390
Provider Name (Legal Business Name): JULIA RHINEHART SMITH LDN,CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 GARDNER DR
WILMINGTON NC
28405-8873
US

IV. Provider business mailing address

2006 LITTLE PALM WAY
WILMINGTON NC
28409-4628
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-5300
  • Fax:
Mailing address:
  • Phone: 910-617-0617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberL001129
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: