Provider Demographics
NPI:1558896571
Name:VANLUVANEE, ABIGAIL (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:VANLUVANEE
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 1:1178 YELLOWWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-6701
Mailing Address - Country:US
Mailing Address - Phone:910-515-8475
Mailing Address - Fax:
Practice Address - Street 1:1642 MILITARY CUTOFF RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5716
Practice Address - Country:US
Practice Address - Phone:910-250-8915
Practice Address - Fax:866-854-3116
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005134133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered