Provider Demographics
NPI:1730343807
Name:KING, MEREDITH LINDSAY (RD)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:LINDSAY
Last Name:KING
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 1:642 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:VASS
Mailing Address - State:NC
Mailing Address - Zip Code:28394-8200
Mailing Address - Country:US
Mailing Address - Phone:910-988-2799
Mailing Address - Fax:
Practice Address - Street 1:115 WILSON RD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-9613
Practice Address - Country:US
Practice Address - Phone:919-775-3725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003164133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered