Healthcare Provider Details

I. General information

NPI: 1972514255
Provider Name (Legal Business Name): CATHERINE AUSTIN MS, RD, LDN, FADA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 JEFFERSON AVE 120
MEMPHIS TN
38104-2127
US

IV. Provider business mailing address

1030 JEFFERSON AVE 120
MEMPHIS TN
38104-2127
US

V. Phone/Fax

Practice location:
  • Phone: 901-577-7440
  • Fax: 901-577-7413
Mailing address:
  • Phone: 901-577-7440
  • Fax: 901-577-7413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code132700000X
TaxonomyDietary Manager
License Number894
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: