Individual
MRS. MARY ELLEN TUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1710 KERNERSVILLE MEDICAL PARKWAY, SUITE 210, KERNERSVILLE, NC 27284-7157
(336) 718-6770
(336) 277-1889
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 718-6770
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001136
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2993130
MEDICARE PTAN
—
Enumeration date
04/13/2008
Last updated
08/02/2013
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