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General NPI Number Information
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NPI Number | 1497855951
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Entity Type | Individual
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Provider Name | LEIGH ANNE CHARLES MA,RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 2230 HORIZON CT
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City | CONOVER
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State | NC
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Zip | 28613-9253
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Country | US
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Telephone | 828-228-1027
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Fax |
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Provider Business Mailing Address
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Address Line | 4610 COUNTRY CLUB RD
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City | WINSTON SALEM
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State | NC
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Zip | 27104-3520
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Country | US
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Telephone | 336-716-8232
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Fax | 336-716-8228
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0254
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License Number State | NC
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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 | L002833
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License Number State | NC
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