Individual
MRS. KAYLIE CHRISMON TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LDN
Contact information
Practice address
1 MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 27157-0001
(336) 713-3058
Mailing address
5250 MOUNTAIN VIEW RD, WINSTON SALEM, NC 27104-5116
(336) 391-4587
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L004906
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86026733
COMMISSION ON DIETETIC REGISTRATION
—
01
—
L004906
NORTH CAROLINA BOARD OF DIETETICS/NUTRITION
NC
Enumeration date
06/04/2019
Last updated
11/27/2023
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