Carly Ann Noe, RD, LDN, CNSC

Individual provider Active NPI Registered Dietitian · College Grove, TN

NPI 1922012145 · NPPES record last updated Nov 27, 2017

Key facts

NPI
1922012145
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2247 (TN)
Practice address
6511 Bridleway Drive
College Grove, TN 37046
Phone
(630) 212-5272
NPI assigned
Jul 27, 2006
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

LicenseStateTypeSpecialty
164.004442ILMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164.004442 IL
Registered Dietitian 133V00000X 2247 TN Yes

Addresses

Primary practice location

6511 Bridleway Drive
College Grove, TN 37046

Mailing address

6511 Bridleway Drive
College Grove, TN 37046
Phone (630) 212-5272

Other names

  • Carly Ann Houston Former name

Other providers in College Grove, TN

All providers in College Grove, TN · Registered Dietitian in Tennessee

Sources for this page

Verify at the official NPI Registry.