Provider Demographics
NPI:1891331609
Name:RAY, LORA DARLENE M (RD, LDN)
Entity Type:Individual
Prefix:
First Name:LORA DARLENE
Middle Name:M
Last Name:RAY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10207 CERNY ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4879
Mailing Address - Country:US
Mailing Address - Phone:919-815-7258
Mailing Address - Fax:
Practice Address - Street 1:10207 CERNY ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4879
Practice Address - Country:US
Practice Address - Phone:919-815-7258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-27
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003484133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered