MEDICARE: NATACHIA DINGLE MS, 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
1	133V00000X	Registered Dietitian	L006625	NC

General Provider Information

NPI Number	:	1659187698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATACHIA DINGLE MS, RD, LDN

Provider Business Mailing Address
First Line	:	12126 LEMMOND FARM DR APT 2508
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-8307
Country	:	US
Telephone Number	:	704-779-1209
Fax Number	:

Provider Business Practice Location Address
First Line	:	12126 LEMMOND FARM DR APT 2508
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-8307
Country	:	US
Telephone Number	:	704-779-1209
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2024
Last Update Date	:	12/11/2024

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