Provider Demographics
NPI:1629194576
Name:DONELSON, KAREN LYNN (RD, LDN, PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LYNN
Last Name:DONELSON
Suffix:
Gender:F
Credentials:RD, LDN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 HOPE HILL RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-9799
Mailing Address - Country:US
Mailing Address - Phone:704-630-6414
Mailing Address - Fax:704-630-6414
Practice Address - Street 1:909 S MAIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-6416
Practice Address - Country:US
Practice Address - Phone:704-630-6414
Practice Address - Fax:704-630-6414
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001180133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered