Provider Demographics
NPI:1306869367
Name:OAKLEY-LANGLEY, ROSE A (RD, LDN)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:A
Last Name:OAKLEY-LANGLEY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:A
Other - Last Name:OAKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1515 SW CARY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6224
Mailing Address - Country:US
Mailing Address - Phone:919-387-3200
Mailing Address - Fax:919-387-3201
Practice Address - Street 1:1515 SW CARY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6224
Practice Address - Country:US
Practice Address - Phone:919-387-3200
Practice Address - Fax:919-387-3201
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000147133N00000X, 133NN1002X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2994594AMedicare PIN
NC2994594BMedicare PIN