Provider Demographics
NPI:1689963936
Name:RHODES, CINDY R (MED, RD, LDN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:R
Last Name:RHODES
Suffix:
Gender:F
Credentials:MED, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 SULGRAVE DR NW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-1351
Mailing Address - Country:US
Mailing Address - Phone:252-290-0399
Mailing Address - Fax:
Practice Address - Street 1:2207 SULGRAVE DR NW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1351
Practice Address - Country:US
Practice Address - Phone:252-290-0399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002105133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered