Individual
PAULA K JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDN
Contact information
Practice address
407 CRUTCHFIELD ST, DURHAM, NC 27704-2726
(919) 470-6516
Mailing address
PO BOX 751274, CHARLOTTE, NC 28275-1274
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
L001052
NC
133NN1002X
Nutrition Education Nutritionist
L001052
NC
133V00000X
Registered Dietitian
L001052
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L001052
LICENSE NUMBER
NC
Enumeration date
11/08/2006
Last updated
10/06/2007
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