MEDICARE: OLESYA HUNTER MS, RD, LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	286965	KY
2	133V00000X	Registered Dietitian	37003827A	IN

General Provider Information

NPI Number	:	1508695784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLESYA HUNTER MS, RD, LD

Provider Business Mailing Address
First Line	:	1021 GREENLEAF RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40213-1115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 TOWN CENTER BLVD STE 103
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-7148
Country	:	US
Telephone Number	:	812-252-2107
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	07/29/2024

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