Individual
PAMELA CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LDN
Contact information
Practice address
2711 X RAY DR STE B, GASTONIA, NC 28054-7491
(704) 884-0064
(704) 884-0074
Mailing address
2711 X RAY DR STE B, GASTONIA, NC 28054-7491
(704) 884-0064
(704) 884-0074
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
L002111
NC
133V00000X
Registered Dietitian
Primary
L002111
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152YR
BCBS NC
NC
Enumeration date
03/04/2009
Last updated
04/22/2015
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