Provider Demographics
NPI:1346405131
Name:MARKER, LISA (MS, RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:MARKER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 SHIRLEY DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3855
Mailing Address - Country:US
Mailing Address - Phone:919-668-1865
Mailing Address - Fax:919-682-4724
Practice Address - Street 1:501 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3888
Practice Address - Country:US
Practice Address - Phone:919-668-1865
Practice Address - Fax:919-682-4724
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003142133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered