Provider Demographics
NPI:1083255210
Name:JOHNSON, DANA ARNDT (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ARNDT
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18137 W CATAWBA AVE
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5641
Mailing Address - Country:US
Mailing Address - Phone:828-234-3060
Mailing Address - Fax:
Practice Address - Street 1:18137 W CATAWBA AVE
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5641
Practice Address - Country:US
Practice Address - Phone:828-234-3060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-29
Last Update Date:2019-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005944133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCL005944OtherNORTH CAROLINA BOARD OF DIETETICS/NUTRITION
NC86149975OtherCOMMISSION ON DIETETIC REGISTRATION