Provider Demographics
NPI:1518558261
Name:LOCKARD, MEREDITH (RDN)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:LOCKARD
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 HADLEY RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-4716
Mailing Address - Country:US
Mailing Address - Phone:919-606-2196
Mailing Address - Fax:
Practice Address - Street 1:823 HADLEY RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-4716
Practice Address - Country:US
Practice Address - Phone:919-606-2196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006140133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered