Doctor Name: | CAROLYN JACKSON |
NPI Number: | 1407223233 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, LDN |
License Number: | L004704 |
Business Practice Address: | 1139 Yale Pl Charlotte, NC - 282091437 |
Business Phone Number: | 9193584822 |
Business Fax Number: | |
Mailing Address: | 1139 Yale Pl, CHARLOTTE |
State: | NC |
Postal Code: | 282091437 |
Phone Number: | 9193584822 |
Fax Number: | |
NPI Enumeration Date: | 08/27/2015 |
NPI Last Update Date: | 08/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | L004704 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |