Provider Demographics
NPI:1164019931
Name:FRIEND, LINDA LEE (NDTR)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:FRIEND
Suffix:
Gender:F
Credentials:NDTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 FOXRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HUBERT
Mailing Address - State:NC
Mailing Address - Zip Code:28539-4533
Mailing Address - Country:US
Mailing Address - Phone:919-917-4000
Mailing Address - Fax:
Practice Address - Street 1:326 FOXRIDGE LN
Practice Address - Street 2:
Practice Address - City:HUBERT
Practice Address - State:NC
Practice Address - Zip Code:28539-4533
Practice Address - Country:US
Practice Address - Phone:919-917-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered