Provider Demographics
NPI:1043847866
Name:TOMLINSON, NATASIA CHANEL (RD, CNSC)
Entity Type:Individual
Prefix:MS
First Name:NATASIA
Middle Name:CHANEL
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:RD, CNSC
Other - Prefix:
Other - First Name:NATASIA
Other - Middle Name:
Other - Last Name:CASPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-5285
Mailing Address - Fax:
Practice Address - Street 1:201 QUEENS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3217
Practice Address - Country:US
Practice Address - Phone:704-316-5285
Practice Address - Fax:704-316-5288
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005671133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered