Provider Demographics
NPI:1972014595
Name:IRVIN, MARGARET (RD, LDN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:IRVIN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DURHAM VA MEDICAL CENTER 508 FULTON STREET
Mailing Address - Street 2:FOOD AND NUTRITION SERVICES
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705
Mailing Address - Country:US
Mailing Address - Phone:919-212-0129
Mailing Address - Fax:
Practice Address - Street 1:DURHAM VA MEDICAL CENTER 508 FULTON STREET
Practice Address - Street 2:NUTRITION AND FOOD SERVICES
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-212-0129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005294133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
86050559OtherCDR