Provider Demographics
NPI:1669116257
Name:MITCHELL, SYDNEY HAYES (RD)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:HAYES
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MONICA DR
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501-8596
Mailing Address - Country:US
Mailing Address - Phone:803-640-6950
Mailing Address - Fax:
Practice Address - Street 1:105 KILMAYNE DR STE B
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4433
Practice Address - Country:US
Practice Address - Phone:919-990-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered