Provider Demographics
NPI:1184322687
Name:NUTRITION CARE OF THE PIEDMONT LLC
Entity type:Organization
Organization Name:NUTRITION CARE OF THE PIEDMONT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN
Authorized Official - Phone:336-955-5859
Mailing Address - Street 1:2990 BETHESDA PL STE 603C
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3314
Mailing Address - Country:US
Mailing Address - Phone:336-955-5859
Mailing Address - Fax:
Practice Address - Street 1:2990 BETHESDA PL STE 603C
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3314
Practice Address - Country:US
Practice Address - Phone:336-955-5859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty