Healthcare Provider Details

I. General information

NPI: 1568986503
Provider Name (Legal Business Name): ALANA SIMS WALLING RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALANA SIMS RD, LDN

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 UNION ST # 1039
SPARTANBURG SC
29306-3629
US

IV. Provider business mailing address

716 UNION ST # 1039
SPARTANBURG SC
29306-3629
US

V. Phone/Fax

Practice location:
  • Phone: 561-316-8373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2021015566
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2367
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLRD3023
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND7986
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: