Provider Demographics
NPI:1215601760
Name:CORREA, KAREN PRISCILLA (RDN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:PRISCILLA
Last Name:CORREA
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:CORREA
Other - Last Name:VILLELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:1005 WANDSWORTH PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-8212
Mailing Address - Country:US
Mailing Address - Phone:704-770-5985
Mailing Address - Fax:
Practice Address - Street 1:3506 W TYVOLA RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-7201
Practice Address - Country:US
Practice Address - Phone:704-329-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered