Provider Demographics
NPI:1144845967
Name:WALKER, CHARLOTTE (RDN, LD)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CEDAR POINT RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-3306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 CEDAR POINT RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824-3306
Practice Address - Country:US
Practice Address - Phone:307-699-6947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1049133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered