Provider Demographics
NPI:1780836478
Name:MCKEON, LINDSEY ANN STROMBERG (RD,LDN, MA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN STROMBERG
Last Name:MCKEON
Suffix:
Gender:F
Credentials:RD,LDN, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 PIEDMONT ROW DR S
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28287-3884
Mailing Address - Country:US
Mailing Address - Phone:704-522-0116
Mailing Address - Fax:
Practice Address - Street 1:6060 PIEDMONT ROW DR S
Practice Address - Street 2:SUITE 120
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28287-3884
Practice Address - Country:US
Practice Address - Phone:704-522-0116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003040133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered