MEDICARE: GRACE ANGELLE VAN METER LDN.RDN

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	5252	TN

General Provider Information

NPI Number	:	1114883766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE ANGELLE VAN METER LDN.RDN

Provider Business Mailing Address
First Line	:	1221 DIVISION ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-4295
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 DIVISION ST APT 209
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-4454
Country	:	US
Telephone Number	:	504-345-4074
Fax Number	:

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

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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