Shelley, Lisa Raynelle

Shelley, Lisa Raynelle is an individual health care provider with primary practice located at 2460 Curtis Ellis Dr , Rocky Mount NC 27804. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Shelley, Lisa Raynelle can be contacted via phone (806) 212-0577.

Contact Information

Primary practice address
2460 Curtis Ellis Dr Rocky Mount NC 27804
Phone: (806) 212-0577
Fax: (806) 212-0563
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X DT80908 Texas
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X L005339 North Carolina

Profile Details

NPI number 1659529378
LBN Legal business name Shelley, Lisa Raynelle
Credentials RD, LD, CDE, BC-ADM
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2008
Last updated Aug 20th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659529378 NPPES
Other 20120483 NCBDE
Other 942472 NCBDE
Other 200913419 NCBDE
Other DT80908 NCBDE

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