Healthcare Provider Details

I. General information

NPI: 1376750547
Provider Name (Legal Business Name): MARY EVA GREGORY M.S., R.D., L.D.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 MERCHANTS WALK
MURFREESBORO TN
37128-2863
US

IV. Provider business mailing address

2602 MERCHANTS WALK
MURFREESBORO TN
37128-2863
US

V. Phone/Fax

Practice location:
  • Phone: 615-210-7620
  • Fax: 615-953-9544
Mailing address:
  • Phone: 615-210-7620
  • Fax: 615-953-9544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number0000000127
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: