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Individual

CHARLOTTE BELL JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MPH, RD, LDN

Contact information

Practice address
231 N JUDD PKWY NE, FUQUAY VARINA, NC 27526-2694
(919) 235-6410
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0351
(919) 350-7687

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L002494
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003143777
NC
Enumeration date
11/17/2009
Last updated
12/15/2022
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