Provider Demographics
NPI:1033583265
Name:BEDINGFIELD, SHAYNA (RD)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:
Last Name:BEDINGFIELD
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 1:128 S 1350 E
Mailing Address - Street 2:
Mailing Address - City:HYRUM
Mailing Address - State:UT
Mailing Address - Zip Code:84319-2029
Mailing Address - Country:US
Mailing Address - Phone:435-200-9319
Mailing Address - Fax:435-200-9319
Practice Address - Street 1:2819 BELCOURT AVE
Practice Address - Street 2:APT UPSTAIRS
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3319
Practice Address - Country:US
Practice Address - Phone:208-709-0398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-27
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2942133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered