Organization
AT HOME NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN J. GLEASON RD, LDN (OWNER/DIETITIAN)
(919) 257-8480
Entity
Organization
Contact information
Practice address
78 TUSCARORA LN, CLAYTON, NC 27520-7367
(919) 576-0079
(919) 516-0917
Mailing address
78 TUSCARORA LN, CLAYTON, NC 27520-7367
(919) 576-0079
(919) 516-0917
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
L002584
NC
133NN1002X
Nutrition Education Nutritionist
L002584
NC
133V00000X
Registered Dietitian
Primary
L002584
NC
133VN1005X
Renal Nutrition Registered Dietitian
L002584
NC
133VN1006X
Metabolic Nutrition Registered Dietitian
L002584
NC
Other
Enumeration date
05/30/2013
Last updated
07/02/2013
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