Basic Information
| Provider Information | |||||||||
| NPI: | 1306073663 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHMIDT | ||||||||
| FirstName: | CHARLOTTE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | RD, LSN, CNSD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 FRIDAY CENTER DR | ||||||||
| Address2: | SUITE 2091, ROOM 2097 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275179499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199665804 | ||||||||
| FaxNumber: | 9199669983 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 MANNING DR | ||||||||
| Address2: | DEPT OF NUTRITION & FOOD SERVICES | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275144220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198430062 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2009 | ||||||||
| LastUpdateDate: | 06/15/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | L002861 | NC | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.