Provider Demographics
NPI:1023397551
Name:ACORNLEY, ASHLEY KRISTEN (RD, LDN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KRISTEN
Last Name:ACORNLEY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10623 KINGSCLERE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6125
Mailing Address - Country:US
Mailing Address - Phone:267-626-9379
Mailing Address - Fax:
Practice Address - Street 1:6200 FALLS OF NEUSE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3563
Practice Address - Country:US
Practice Address - Phone:267-626-9379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1004398133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered