Lisa Duncan Davis, MS RD LDN CNSC

Individual provider Active NPI Registered Dietitian · Blountville, TN

NPI 1194223727 · NPPES record last updated Jan 29, 2018

Key facts

NPI
1194223727
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LDN0000001530 (TN)
Practice address
217 Harr Town Rd
Blountville, TN 37617-3830
Phone
(423) 863-4735
NPI assigned
Jan 29, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LDN0000001530TNMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LDN0000001530 TN Yes

Addresses

Primary practice location

217 Harr Town Rd
Blountville, TN 37617-3830

Mailing address

217 Harr Town Rd
Blountville, TN 37617-3830
Phone (423) 863-4735

Other providers in Blountville, TN

All providers in Blountville, TN · Registered Dietitian in Tennessee

Sources for this page

Verify at the official NPI Registry.