Provider Demographics
NPI:1952940074
Name:PEDRAZA, WENDY COLOMBO (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:COLOMBO
Last Name:PEDRAZA
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 SHAFTSBERRY CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7751
Mailing Address - Country:US
Mailing Address - Phone:919-673-8100
Mailing Address - Fax:
Practice Address - Street 1:15 E PEACE ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1176
Practice Address - Country:US
Practice Address - Phone:919-673-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006005133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered