Individual
MRS. LISA WILSON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, MS, LDN
Contact information
Practice address
11200 GALLERIA AVENUE, RALEIGH, NC 27614
(919) 570-1511
(919) 570-7751
Mailing address
211 FRIDAY CENTER DR, SUITE 2091, ROOM 2094 HEDRICK BUILDING, CHAPEL HILL, NC 27517-9499
(984) 974-1191
(984) 974-1311
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
L002570
NC
133V00000X
Registered Dietitian
Primary
L002570
NC
Other
Enumeration date
05/15/2007
Last updated
07/15/2015
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