Individual
AMANDA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LDN
Contact information
Practice address
401 N MAIN ST, KENANSVILLE, NC 28349-8801
(910) 296-2747
Mailing address
PO BOX 278, KENANSVILLE, NC 28349-0278
(910) 296-2747
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005094
NC
Other
Enumeration date
05/16/2017
Last updated
05/16/2017
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