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NPI Code Detail

MEDICARE: KAREN RENKEN ANDERSON RD, LD

MEDICARE: KAREN RENKEN ANDERSON RD, LD
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
1133V00000XRegistered DietitianLDN00005TN

General Provider Information

NPI Number : 1649222456
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN RENKEN ANDERSON RD, LD
Provider Business Mailing Address
First Line : 313 N MAIN ST
Second Line :
City : ASHLAND CITY
State : TN
Zip : 37015-1319
Country : US
Telephone Number : 615-792-1911
Fax Number : 615-792-0619
Provider Business Practice Location Address
First Line : 313 N MAIN ST
Second Line :
City : ASHLAND CITY
State : TN
Zip : 37015-1319
Country : US
Telephone Number : 615-792-1911
Fax Number : 615-792-0619
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 07/08/2007

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