Provider Demographics
NPI:1407045107
Name:DANCHI, DIANE LYNNETTE (LDN, RD)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:LYNNETTE
Last Name:DANCHI
Suffix:
Gender:F
Credentials:LDN, RD
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:LYNNETTE
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 FRIDAY CENTER DR
Mailing Address - Street 2:SUITE 2091, ROOM 2094 HEDRICK BUILDING
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9499
Mailing Address - Country:US
Mailing Address - Phone:984-974-1191
Mailing Address - Fax:984-974-1311
Practice Address - Street 1:1515 SW CARY PARKWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6225
Practice Address - Country:US
Practice Address - Phone:919-387-0080
Practice Address - Fax:919-387-3908
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000710133N00000X, 133V00000X
NC000710133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ50644AOtherMEDICARE PTAN
NCQ50644E853OtherMEDICARE PTAN