Healthcare Provider Details

I. General information

NPI: 1659588747
Provider Name (Legal Business Name): KRYSTAL HOLLINGSWORTH BURNS 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: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 MEMORIAL BLVD
MURFREESBORO TN
37129-1522
US

IV. Provider business mailing address

126 WHITTLE CT
MURFREESBORO TN
37128-5793
US

V. Phone/Fax

Practice location:
  • Phone: 615-895-0186
  • Fax: 615-278-3355
Mailing address:
  • Phone: 615-867-7589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number0000001144
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: