Provider Demographics
NPI:1588123129
Name:AIKEN, RACHEL (RD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:AIKEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 RIDLEY ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-2726
Mailing Address - Country:US
Mailing Address - Phone:919-307-7414
Mailing Address - Fax:
Practice Address - Street 1:1816 RIDLEY ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-2726
Practice Address - Country:US
Practice Address - Phone:919-307-7414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005688133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered