Provider Demographics
NPI:1699722835
Name:THOMPSON, CAROL (RD, LDN)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1605
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-1605
Mailing Address - Country:US
Mailing Address - Phone:828-264-0405
Mailing Address - Fax:828-262-9958
Practice Address - Street 1:350 BLUE RIDGE VIS
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-9168
Practice Address - Country:US
Practice Address - Phone:828-264-0405
Practice Address - Fax:828-262-9958
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000656133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered