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General NPI Number Information
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NPI Number | 1740344159
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Entity Type | Individual
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Provider Name | ELIZABETH DIANE LOOSEMORE PH.D., R.D., L.D.N.
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Gender | Female
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 02/02/2011
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Provider Practice Location Address
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Address Line | 2 MEDICAL PARK DR STE 102 MISSION WEIGHT MANAGEMENT CENTER
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City | ASHEVILLE
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State | NC
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Zip | 28803-2425
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Country | US
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Telephone | 828-213-4102
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Fax |
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Provider Business Mailing Address
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Address Line | 7 HOOPERS FOREST DR
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City | FLETCHER
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State | NC
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Zip | 28732-7588
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Country | US
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Telephone | 828-676-6627
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Fax |
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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 | L003151
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License Number State | NC
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