Provider Demographics
NPI:1336721398
Name:ACQUANITA, HALLEE (MS, RD, LD, CDCES)
Entity type:Individual
Prefix:
First Name:HALLEE
Middle Name:
Last Name:ACQUANITA
Suffix:
Gender:F
Credentials:MS, RD, LD, CDCES
Other - Prefix:
Other - First Name:HALLEE
Other - Middle Name:
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD, CDCES
Mailing Address - Street 1:2693 IMPULSION DR
Mailing Address - Street 2:
Mailing Address - City:NEW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27562-9344
Mailing Address - Country:US
Mailing Address - Phone:618-972-4035
Mailing Address - Fax:
Practice Address - Street 1:6801 PLEASANT PINES DR STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1939
Practice Address - Country:US
Practice Address - Phone:919-990-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
NCL006854133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered