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General NPI Number Information
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NPI Number | 1104642859
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Entity Type | Organization
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Legal Business Name | RDNUTRITION LLC
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 3103 SHANNON RD
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City | DURHAM
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State | NC
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Zip | 27707-4336
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Country | US
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Telephone | 919-865-3869
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Fax | 919-865-3869
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Provider Business Mailing Address
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Address Line | 1025 WADE AVE
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City | RALEIGH
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State | NC
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Zip | 27605-1158
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Country | US
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Telephone | 919-865-3869
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Fax | 919-865-3869
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Authorized Official
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Title or Position | VP OF OPERATIONS/DELEGATED OFFICIAL
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Name | LINDSEY BRITT
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Credential |
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Telephone | 570-952-1627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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