Provider Demographics
NPI:1497281117
Name:LUTZ, ANNA METZ (MPH, RD, LDN, CEDRD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:METZ
Last Name:LUTZ
Suffix:
Gender:F
Credentials:MPH, RD, LDN, CEDRD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4650
Mailing Address - Country:US
Mailing Address - Phone:919-781-4500
Mailing Address - Fax:919-781-4504
Practice Address - Street 1:4000 BLUE RIDGE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4650
Practice Address - Country:US
Practice Address - Phone:919-781-4500
Practice Address - Fax:919-781-4504
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002702133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered