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Organization
LAKE NORMAN NUTRITITION ASSOCIATES, LLC
Active
Organization
LAKE NORMAN NUTRITITION ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTIN SCHWARZ WOOTEN MS,RD,LDN,CDE (OWNER AND PARTNER)
(704) 895-9865
Entity
Organization
Contact information
Practice address
3535 RANDOLPH RD, SUITE 210, CHARLOTTE, NC 28211-1032
(704) 895-9865
(704) 895-9870
Mailing address
19809B NORTHCOVE RD, SUITE 108, CORNELIUS, NC 28031-6445
(704) 895-9865
(704) 895-9870
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001079
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0154292
CIGNA
NC
01
—
7581332
AETNA, BCBS
NC
Enumeration date
03/15/2007
Last updated
08/22/2020
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