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General NPI Number Information
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NPI Number | 1275732752
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Entity Type | Individual
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Provider Name | LINDA MOORE PENNINGTON M.S., R.D., LDN
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Gender | Female
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 591 MERRIWEATHER DR
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City | COLLIERVILLE
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State | TN
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Zip | 38017-1685
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Country | US
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Telephone | 901-759-9337
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Fax | 901-759-7967
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Provider Business Mailing Address
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Address Line | PO BOX 81
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City | COLLIERVILLE
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State | TN
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Zip | 38027-0081
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Country | US
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Telephone | 901-759-9337
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Fax | 901-759-7967
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 918
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | D0936
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 772
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License Number State | TN
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