Provider Demographics
NPI:1225813470
Name:ECKHARDT, MEBETTE (MA, RD, LDN)
Entity Type:Individual
Prefix:
First Name:MEBETTE
Middle Name:
Last Name:ECKHARDT
Suffix:
Gender:F
Credentials:MA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 MEADOWCREEK DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-7704
Mailing Address - Country:US
Mailing Address - Phone:919-622-1044
Mailing Address - Fax:
Practice Address - Street 1:147 W KING ST
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2543
Practice Address - Country:US
Practice Address - Phone:919-234-7448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002884133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered