Healthcare Provider Details

I. General information

NPI: 1770001802
Provider Name (Legal Business Name): BETTY LOU TURNBOW RDN,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BETTY LOU FONES RDN,LDN

II. Dates (important events)

Enumeration Date: 09/09/2017
Last Update Date: 09/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 GERMANTOWN BEND CV
CORDOVA TN
38018-7238
US

IV. Provider business mailing address

74 HAVERHILL DR
JACKSON TN
38305-8506
US

V. Phone/Fax

Practice location:
  • Phone: 901-759-9337
  • Fax: 901-759-7967
Mailing address:
  • Phone: 731-616-5631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number657
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: