Provider Demographics
NPI:1770212680
Name:LONG, CINDY (MS, RD, LDN, CDCES)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:LONG
Suffix:
Gender:F
Credentials:MS, RD, LDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MEDFIELD CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9617
Mailing Address - Country:US
Mailing Address - Phone:480-444-9544
Mailing Address - Fax:
Practice Address - Street 1:10208 CERNY ST STE 301
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-1000
Practice Address - Country:US
Practice Address - Phone:919-354-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered