Provider Demographics
NPI:1831790286
Name:ECKHOFF, DEMI LANE (RDN)
Entity type:Individual
Prefix:
First Name:DEMI
Middle Name:LANE
Last Name:ECKHOFF
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CARRAWAY XING STE 2404
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-7093
Mailing Address - Country:US
Mailing Address - Phone:919-590-0558
Mailing Address - Fax:
Practice Address - Street 1:1212 MANN DR STE 100
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5511
Practice Address - Country:US
Practice Address - Phone:919-590-0558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006272133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCL006272OtherLDN