Rosetta Bradford, RDN
Individual provider Active NPI Registered Dietitian · Hermitage, TN
NPI 1326411489 · NPPES record last updated Nov 10, 2015
Key facts
- NPI
- 1326411489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- LDN0000001127 (TN)
- Practice address
- 6015 Port Anadarko TRL
Hermitage, TN 37076-3117 - Phone
- (615) 885-1922
- Fax
- (615) 885-1922
- NPI assigned
- Nov 10, 2015
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDN0000001127 | TN | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LDN0000001127 | TN | Yes |
Addresses
Primary practice location
6015 Port Anadarko TRL
Hermitage, TN 37076-3117
Mailing address
6015 Port Anadarko TRL
Hermitage, TN 37076-3117
Phone (615) 885-1922
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C31 | Medicaid | TN |
Other providers in Hermitage, TN
- Homa Boms
- Melissa Dawn Bond
- Molly Boring
- Camille Bourne
- Alisa Roseann Bowersock
- Bradley Health Care, Inc
- Alexa Bradshaw
- Zachary Braver
- Stephanie Brewer
- Tara Brewer
All providers in Hermitage, TN · Registered Dietitian in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.