Provider Demographics
NPI:1447497342
Name:CRISP, DANA MERCER (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MERCER
Last Name:CRISP
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 1:563 JUTTS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28771-7274
Mailing Address - Country:US
Mailing Address - Phone:828-479-4052
Mailing Address - Fax:828-479-4052
Practice Address - Street 1:21 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28771-9054
Practice Address - Country:US
Practice Address - Phone:828-479-7900
Practice Address - Fax:828-479-6956
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002615133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered