Provider Demographics
NPI:1134318843
Name:HONEYCUTT, ASHLEY MILES (LDN, RD)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:MILES
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:LDN, RD
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:LYNNE
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LDN,RD
Mailing Address - Street 1:211 FRIDAY CENTER DR
Mailing Address - Street 2:SUITE 2091, ROOM 2094 HEDRICK BUILDING
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9499
Mailing Address - Country:US
Mailing Address - Phone:984-974-1191
Mailing Address - Fax:984-974-1311
Practice Address - Street 1:4200 LAKE BOONE TRL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6521
Practice Address - Country:US
Practice Address - Phone:919-784-1371
Practice Address - Fax:919-784-1397
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002818133N00000X, 133V00000X
NC002818133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ50640E853OtherMEDICARE PTAN
NCQ50640AOtherMEDICARE PTAN