Doctor Name: | MRS. AUTUMN P DOUGLAS |
NPI Number: | 1942522156 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | D1242 |
Business Practice Address: | 1040 River Oaks Dr Ste. 302 Jackson, MS - 392329530 |
Business Phone Number: | 6019399923 |
Business Fax Number: | 6019399924 |
Mailing Address: | 3322 W End Ave, 11th Floor NASHVILLE |
State: | TN |
Postal Code: | 372031031 |
Phone Number: | 6155159880 |
Fax Number: | 6155159881 |
NPI Enumeration Date: | 02/16/2010 |
NPI Last Update Date: | 03/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | D1242 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
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 |