Provider Demographics
NPI:1134837180
Name:CHADWICK, OLIVIA SHEA (RD)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:SHEA
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4236 ROCKSIDE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-6315
Mailing Address - Country:US
Mailing Address - Phone:804-301-2281
Mailing Address - Fax:
Practice Address - Street 1:8921 HOLLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-9197
Practice Address - Country:US
Practice Address - Phone:919-657-9622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered