Provider Demographics
NPI:1487790457
Name:WILLIAMSON, DONNA RICHARDS (RDN (REGISTERED DIET)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:RICHARDS
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:RDN (REGISTERED DIET
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:RICHARDS
Other - Last Name:FALKENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2225 FREEDOM DRIVE SUITE 8
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208
Practice Address - Country:US
Practice Address - Phone:704-384-7390
Practice Address - Fax:704-384-5669
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
811999133V00000X
NCL005144133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered