Provider Demographics
NPI:1134874381
Name:BAILEY, ASHLEY (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SAS CAMPUS DR BLDG W1352
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8617
Mailing Address - Country:US
Mailing Address - Phone:919-531-3050
Mailing Address - Fax:
Practice Address - Street 1:700 RESEARCH DRIVE
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2751
Practice Address - Country:US
Practice Address - Phone:919-531-8809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1006056133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered