Provider Demographics
NPI:1154740785
Name:OLIVER, KACI PLEASANTS (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:KACI
Middle Name:PLEASANTS
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:KACI
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6402 MCCRIMMON PKWY
Mailing Address - Street 2:#100
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8138
Mailing Address - Country:US
Mailing Address - Phone:919-655-1000
Mailing Address - Fax:919-655-1001
Practice Address - Street 1:6402 MCCRIMMON PKWY
Practice Address - Street 2:#100
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8138
Practice Address - Country:US
Practice Address - Phone:919-655-1000
Practice Address - Fax:919-655-1001
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004552133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered