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General NPI Number Information
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NPI Number | 1508288119
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Entity Type | Individual
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Provider Name | MADELEINE HAMILTON HALLUM RD, CSG, LDN
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Gender | Female
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Dates
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Enumeration Date | 01/16/2014
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Last Update Date | 01/16/2014
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Provider Practice Location Address
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Address Line | 1211 21ST AVE S 607 MEDICAL ARTS BUILDING
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City | NASHVILLE
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State | TN
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Zip | 37232-1320
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Country | US
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Telephone | 615-936-3952
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Fax | 615-936-3956
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Provider Business Mailing Address
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Address Line | 4730 GARCIA BLVD
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City | MURFREESBORO
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State | TN
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Zip | 37128-3852
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Country | US
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Telephone | 251-591-8851
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Fax |
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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 | 112335722
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License Number State | TN
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