Provider Demographics
NPI:1114818325
Name:SELL, MADISON (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:SELL
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4565 CAMELLIA LN
Mailing Address - Street 2:
Mailing Address - City:WALKERTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27051-9523
Mailing Address - Country:US
Mailing Address - Phone:704-876-5005
Mailing Address - Fax:
Practice Address - Street 1:211 W LEXINGTON AVE STE 104
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2570
Practice Address - Country:US
Practice Address - Phone:336-781-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL008689133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered