Provider Demographics
NPI:1033511381
Name:NO, JUDY MARIE (RD)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:MARIE
Last Name:NO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 EAST HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:FORT EISENHOWER
Mailing Address - State:GA
Mailing Address - Zip Code:30905-9998
Mailing Address - Country:US
Mailing Address - Phone:706-787-5915
Mailing Address - Fax:
Practice Address - Street 1:2555 GEORGETOWN RD NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3562
Practice Address - Country:US
Practice Address - Phone:423-339-1415
Practice Address - Fax:423-339-1715
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN2738133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered