Doctor Name: | MRS. KIMBERLY EILEEN CREDLE |
NPI Number: | 1154518256 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, BSN, RD, LD |
License Number: | LD002413 |
Business Practice Address: | 1230 Baxter St Athens, GA - 306063712 |
Business Phone Number: | 7063892150 |
Business Fax Number: | 7063892151 |
Mailing Address: | 1230 Baxter St, ATHENS |
State: | GA |
Postal Code: | 306063712 |
Phone Number: | 7063892150 |
Fax Number: | 7063892151 |
NPI Enumeration Date: | 10/02/2007 |
NPI Last Update Date: | 10/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | LD002413 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |