Healthcare Provider Details

I. General information

NPI: 1730410044
Provider Name (Legal Business Name): JULIANN MARIE CHAVEZ PHD, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIANN MARIE WALKER CHAVEZ MS,RD, LDN

II. Dates (important events)

Enumeration Date: 01/26/2010
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 E WEISGARBER RD STE 200
KNOXVILLE TN
37909-2686
US

IV. Provider business mailing address

7319 LORIMAR PL
KNOXVILLE TN
37919-8168
US

V. Phone/Fax

Practice location:
  • Phone: 865-588-3525
  • Fax: 865-558-6153
Mailing address:
  • Phone: 865-406-7543
  • Fax: 865-691-5515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLDN0000001244
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License NumberLDN0000001244
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: