Provider Demographics
NPI:1386489987
Name:CHUNG, ISABEL (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 MACY GRV
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9620
Mailing Address - Country:US
Mailing Address - Phone:919-265-4670
Mailing Address - Fax:
Practice Address - Street 1:1 STONE CENTER DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27515
Practice Address - Country:US
Practice Address - Phone:919-265-4670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL007729133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics