MEDICARE: TAYLOR KOENIGS 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	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian		TN

General Provider Information

NPI Number	:	1194434456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR KOENIGS RDN

Provider Business Mailing Address
First Line	:	2450 SUNRISE RIDGE WAY APT 302
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37921-1262
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 SUNRISE RIDGE WAY APT 302
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37921-1262
Country	:	US
Telephone Number	:	865-909-7609
Fax Number	:	865-240-3169

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

Provider Enumeration Date	:	11/15/2022
Last Update Date	:	02/18/2023

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