Provider Demographics
NPI:1003359449
Name:MITCHELL, ANIA (RD)
Entity type:Individual
Prefix:
First Name:ANIA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4609 MARATHON LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-0790
Mailing Address - Country:US
Mailing Address - Phone:203-543-5786
Mailing Address - Fax:
Practice Address - Street 1:4609 MARATHON LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-0790
Practice Address - Country:US
Practice Address - Phone:203-543-5786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-01
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006958133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered