Basic Information
Provider Information
NPI: 1003005760
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARMSTRONG
FirstName: BARBARA
MiddleName: ASCAH
NamePrefix: MRS.
NameSuffix:  
Credential: RD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2066 HIGHWAY 125
Address2:  
City: ROANOKE RAPIDS
State: NC
PostalCode: 27870
CountryCode: US
TelephoneNumber: 2525365000
FaxNumber: 2525362258
Practice Location
Address1: 2066 HIGHWAY 125
Address2:  
City: ROANOKE RAPIDS
State: NC
PostalCode: 27870
CountryCode: US
TelephoneNumber: 2525365000
FaxNumber: 2525362258
Other Information
ProviderEnumerationDate: 10/18/2007
LastUpdateDate: 10/18/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000XL000501NCY Dietary & Nutritional Service ProvidersDietitian, Registered 

ID Information
IDTypeStateIssuerDescription
L00050101NCLICENSUREOTHER
32891501 DIETETIC REGISTRATIONOTHER


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