Provider Demographics
NPI:1104469501
Name:CARLTON, KALIE RAE (RD, LDN)
Entity type:Individual
Prefix:
First Name:KALIE
Middle Name:RAE
Last Name:CARLTON
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:KALIE
Other - Middle Name:RAE
Other - Last Name:PEYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:111 RIDGEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:NC
Mailing Address - Zip Code:28701-8730
Mailing Address - Country:US
Mailing Address - Phone:502-321-4217
Mailing Address - Fax:
Practice Address - Street 1:31 COLLEGE PL STE 200
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1409
Practice Address - Country:US
Practice Address - Phone:828-333-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004833133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered