Provider Demographics
NPI:1205695848
Name:HOLLINGSWORTH, BRIDGET (RD)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:HOLLINGSWORTH
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 1:2612 SARAH AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1940
Mailing Address - Country:US
Mailing Address - Phone:919-391-3659
Mailing Address - Fax:
Practice Address - Street 1:115 MARKET ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3251
Practice Address - Country:US
Practice Address - Phone:919-335-3828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003808133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered