Provider Demographics
NPI:1871029520
Name:ALEXANDER, SHAUNA (RD)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BLUE RIDGE RD STE 140
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4637
Mailing Address - Country:US
Mailing Address - Phone:919-781-4500
Mailing Address - Fax:919-781-4504
Practice Address - Street 1:4000 BLUE RIDGE RD STE 140
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4637
Practice Address - Country:US
Practice Address - Phone:919-781-4500
Practice Address - Fax:919-781-4504
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered