Provider Demographics
NPI:1467641407
Name:HORRELL, MARY ELIZABETH (RD, CDE)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:HORRELL
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 ANDERSON BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-6301
Mailing Address - Country:US
Mailing Address - Phone:828-213-4634
Mailing Address - Fax:828-213-4647
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:SUITE 3200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4550
Practice Address - Country:US
Practice Address - Phone:828-213-4634
Practice Address - Fax:828-213-4647
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000598133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered