Healthcare Provider Details

I. General information

NPI: 1700690757
Provider Name (Legal Business Name): ALLISON HOLLADAY NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2025
Last Update Date: 02/01/2025
Certification Date: 02/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3919 DRUID HILLS RD
LOUISVILLE KY
40207-2017
US

IV. Provider business mailing address

3919 DRUID HILLS RD
LOUISVILLE KY
40207-2017
US

V. Phone/Fax

Practice location:
  • Phone: 502-974-3606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: KATIE HOLLADAY
Title or Position: REGISTERED DIETITIAN
Credential:
Phone: 502-974-3606