Provider Demographics
NPI:1558739466
Name:POPE, CAROLINE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:POPE
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 1:2501 BLUE RIDGE RD
Mailing Address - Street 2:SUITE G130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6479
Mailing Address - Country:US
Mailing Address - Phone:919-594-1885
Mailing Address - Fax:
Practice Address - Street 1:2501 BLUE RIDGE RD
Practice Address - Street 2:SUITE G130
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6479
Practice Address - Country:US
Practice Address - Phone:919-594-1885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004668133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered