Healthcare Provider Details

I. General information

NPI: 1952265795
Provider Name (Legal Business Name): ADRIA BUTLER MS,RD,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 E GETWELL LOOP
MEMPHIS TN
38152-4210
US

IV. Provider business mailing address

4300 W UNION RD
MILLINGTON TN
38053-4422
US

V. Phone/Fax

Practice location:
  • Phone: 901-417-0540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1501X
TaxonomySports Dietetics Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: