MEDICARE: AMBER WORTHEN RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LDN00920	RI

General Provider Information

NPI Number	:	1073032256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER WORTHEN RD

Provider Business Mailing Address
First Line	:	100 POWELL PL # 1441
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-3622
Country	:	US
Telephone Number	:	866-719-9611
Fax Number	:	901-284-2536

Provider Business Practice Location Address
First Line	:	195 BROADWAY
Second Line	:
City	:	NEWPORT
State	:	RI
Zip	:	02840-2610
Country	:	US
Telephone Number	:	401-619-0663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2017
Last Update Date	:	04/29/2026

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