Provider Demographics
NPI:1588386072
Name:CODY, GENEVIEVE MARRIN (RDN)
Entity type:Individual
Prefix:MRS
First Name:GENEVIEVE
Middle Name:MARRIN
Last Name:CODY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 LANDOVER CIR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-8482
Mailing Address - Country:US
Mailing Address - Phone:917-623-4295
Mailing Address - Fax:
Practice Address - Street 1:205 LANDOVER CIR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-8482
Practice Address - Country:US
Practice Address - Phone:917-623-4295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004892133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered