Individual
JEANNE A DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LDN
Contact information
Practice address
730 HIGHLAND OAKS DR, WINSTON SALEM, NC 27103-7154
(336) 646-7323
(336) 646-7787
Mailing address
PO BOX 604050, CHARLOTTE, NC 28260-4050
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L006167
NC
Other
Enumeration date
09/04/2020
Last updated
08/13/2021
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