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General NPI Number Information
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NPI Number | 1669099172
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Entity Type | Individual
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Provider Name | LESLEY GRAYCE STANFORD MS, RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 06/30/2020
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Last Update Date | 06/30/2020
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Provider Practice Location Address
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Address Line | 1509 RIDGE LN
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City | HILLSBOROUGH
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State | NC
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Zip | 27278-9425
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Country | US
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Telephone | 919-684-5068
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Fax |
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Provider Business Mailing Address
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Address Line | 315 HANES HOUSE DUKE UNIVERSITY MEDICAL CENTER ROOM 375
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City | DURHAM
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State | NC
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Zip | 27710-0001
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Country | US
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Telephone | 919-684-5068
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Fax | 919-684-4836
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | L000608
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License Number State | NC
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