Provider Demographics
NPI:1003474206
Name:GONZALEZ ADAMS, XAYMARA YEVETTE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:XAYMARA
Middle Name:YEVETTE
Last Name:GONZALEZ ADAMS
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 CROWNE BROOK CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2612
Mailing Address - Country:US
Mailing Address - Phone:787-637-1202
Mailing Address - Fax:
Practice Address - Street 1:5201 CHARLOTTE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3320
Practice Address - Country:US
Practice Address - Phone:615-222-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3500133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered