Provider Demographics
NPI:1407555204
Name:GORSKI, ISABELLA (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:GORSKI
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 PRATT ST STE 5000
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3976
Mailing Address - Country:US
Mailing Address - Phone:919-681-8604
Mailing Address - Fax:
Practice Address - Street 1:2400 PRATT ST STE 5000
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3976
Practice Address - Country:US
Practice Address - Phone:919-681-8604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL007149133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
86153982OtherACADEMY OF NUTRITION AND DIETITICS
NCL007149OtherNORTH CAROLINA BOARD OF DIETETICS/ NUTRITION