Provider Demographics
NPI:1598178071
Name:CALHOUN, VIRGINIA GRAE (RD, LDN, CDCES)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:GRAE
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:RD, LDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:984-215-4189
Mailing Address - Fax:
Practice Address - Street 1:1600 PERIMETER PARK DR
Practice Address - Street 2:SUITE 225
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8421
Practice Address - Country:US
Practice Address - Phone:919-804-5124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004254133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered