Individual
ALLISON DELUCCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, RDN
Contact information
Practice address
3480 WAKE FOREST RD STE 500, RALEIGH, NC 27609
(919) 684-6437
Mailing address
3600 WILLOW BLUFF DR, RALEIGH, NC 27604-6059
(360) 991-9416
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
L005880
NC
363A00000X
Physician Assistant
Primary
0010-09359
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-09359
NORTH CAROLINA MEDICAL BOARD: PA-C LICENSE
NC
01
—
1166067
NCCPA PA-C CERTIFICATION
—
01
—
86015002
COMMISSION ON DIETETIC REGISTRATION: REGISTERED DIETITIAN/NUTRITIONIST
—
01
—
L005880
NORTH CAROLINA BOARD OF DIETETICS AND NUTRITION: NC RDN LICENSE
NC
Enumeration date
01/26/2015
Last updated
04/09/2024
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