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Organization
WELL BALANCED NUTRITION, LLC
Active
Organization
WELL BALANCED NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCY A HAYHURST RDN, LDN (CEO)
(919) 491-2004
Entity
Organization
Contact information
Practice address
2544 BURTON RD, DURHAM, NC 27704-3809
(919) 491-2004
Mailing address
2544 BURTON RD, DURHAM, NC 27704-3809
(919) 491-2004
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
L003447
NC
133N00000X
Nutritionist
L003670
NC
133V00000X
Registered Dietitian
Primary
L003447
NC
133V00000X
Registered Dietitian
L003670
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19DNY0
BLUE CROSS BLUE SHIELD
NC
Enumeration date
04/08/2016
Last updated
04/08/2016
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