Provider Demographics
NPI:1497979884
Name:LAMBERSON, JOHN HARTNETT (RD, CDE)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HARTNETT
Last Name:LAMBERSON
Suffix:
Gender:M
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 1:1001 LESSIE LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-4583
Mailing Address - Country:US
Mailing Address - Phone:252-335-9355
Mailing Address - Fax:252-338-4190
Practice Address - Street 1:1001 LESSIE LN
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4583
Practice Address - Country:US
Practice Address - Phone:252-335-9355
Practice Address - Fax:252-338-4190
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001879133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered