Healthcare Provider Details

I. General information

NPI: 1477473403
Provider Name (Legal Business Name): HANNAH LIBBY MS, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 PEABODY AVE
MEMPHIS TN
38104-3500
US

IV. Provider business mailing address

129 DIXIE WAY
STARKVILLE MS
39759-9046
US

V. Phone/Fax

Practice location:
  • Phone: 901-321-5803
  • Fax:
Mailing address:
  • Phone: 662-610-8244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2945
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: