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NPI Code Detail

MEDICARE: MRS. DANA MERCER CRISP RD, LDN

MEDICARE: MRS. DANA MERCER CRISP RD, LDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianL002615NC

General Provider Information

NPI Number : 1447497342
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANA MERCER CRISP RD, LDN
Provider Business Mailing Address
First Line : 563 JUTTS CREEK RD
Second Line :
City : ROBBINSVILLE
State : NC
Zip : 28771-7274
Country : US
Telephone Number : 828-479-4052
Fax Number : 828-479-4052
Provider Business Practice Location Address
First Line : 21 S MAIN ST
Second Line :
City : ROBBINSVILLE
State : NC
Zip : 28771-9054
Country : US
Telephone Number : 828-479-7900
Fax Number : 828-479-6956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2009
Last Update Date : 01/14/2009

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