Provider Demographics
NPI:1740616994
Name:HOLLINGSWORTH, TAYLOR (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:FORD
Other - Last Name:LOFTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7200
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-0200
Mailing Address - Country:US
Mailing Address - Phone:252-937-0200
Mailing Address - Fax:252-451-0056
Practice Address - Street 1:3708 FORESTVIEW RD STE 205
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612
Practice Address - Country:US
Practice Address - Phone:919-354-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003825133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered