Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 4015 | NC |
N | 111NN1001X | Nutrition | X011286-1 | NY |
NPI | 1295802676 |
---|---|
Provider Name | Dr. Suzanne Lucille Fox |
First Address | Chapel Hill, NC 27517-2396 |
Second Address | Chapel Hill, NC 27517-2396 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 12/05/2011 |