Healthcare Provider Details

I. General information

NPI: 1649181082
Provider Name (Legal Business Name): JORDAN CLAIRE LYONS MS, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NEW YORK AVE
OAK RIDGE TN
37830-5212
US

IV. Provider business mailing address

200 NEW YORK AVE
OAK RIDGE TN
37830-5212
US

V. Phone/Fax

Practice location:
  • Phone: 865-835-5400
  • Fax: 865-835-5401
Mailing address:
  • Phone: 865-835-5400
  • Fax: 865-835-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number4989
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: