Provider Demographics
NPI:1265180384
Name:WADDELL, BRITTANY MORGAN (RD, LDN, CNSC)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MORGAN
Last Name:WADDELL
Suffix:
Gender:F
Credentials:RD, LDN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8804 TEMPEST RDG
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1351
Mailing Address - Country:US
Mailing Address - Phone:910-840-9275
Mailing Address - Fax:
Practice Address - Street 1:8804 TEMPEST RDG
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1351
Practice Address - Country:US
Practice Address - Phone:910-840-9275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1045215133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty