Provider Demographics
NPI:1023538964
Name:NOEL, AMELIA DONNA (RDN, LD)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:DONNA
Last Name:NOEL
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:DONNA
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:
Practice Address - Street 1:9997 CARVER RD FL 4
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-5537
Practice Address - Country:US
Practice Address - Phone:513-607-3365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173833133V00000X
MEDI1486133V00000X
NH1078133V00000X
MO2019043505133V00000X
VT74.0134199133V00000X
OH8020133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered