Healthcare Provider Details

I. General information

NPI: 1306524020
Provider Name (Legal Business Name): SHERREE A TELFORD RD LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 TRACESIDE DR
NASHVILLE TN
37221-4084
US

IV. Provider business mailing address

5540 TRACESIDE DR
NASHVILLE TN
37221-4084
US

V. Phone/Fax

Practice location:
  • Phone: 615-972-5718
  • Fax:
Mailing address:
  • Phone: 615-972-5718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number0000001618
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: