Provider Demographics
NPI:1801493291
Name:FUEL NC NUTRITION
Entity type:Organization
Organization Name:FUEL NC NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:STEPHAN
Authorized Official - Last Name:SCHWOCHERT
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN, CSCS, MPH
Authorized Official - Phone:321-412-0761
Mailing Address - Street 1:1107 CAPITAL BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1107 CAPITAL BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1113
Practice Address - Country:US
Practice Address - Phone:321-412-0761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty