Healthcare Provider Details

I. General information

NPI: 1891188827
Provider Name (Legal Business Name): ELAINA EFIRD RD, CEDS-S, CSSD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 ASHBURN PL
GREENVILLE SC
29615-3605
US

IV. Provider business mailing address

21 ASHBURN PL
GREENVILLE SC
29615-3605
US

V. Phone/Fax

Practice location:
  • Phone: 919-685-5471
  • Fax:
Mailing address:
  • Phone: 919-685-5471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number074.0130951
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX6178
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3053
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: