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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