Provider Demographics
NPI:1114357704
Name:HOLMES, MARILYN CHATTIN (RD)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:CHATTIN
Last Name:HOLMES
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:HEALTH PLUS
Mailing Address - Street 2:201 25TH AVENUE SOUTH
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37240-0001
Mailing Address - Country:US
Mailing Address - Phone:615-343-2638
Mailing Address - Fax:615-343-3029
Practice Address - Street 1:HEALTH PLUS
Practice Address - Street 2:201 25TH AVENUE SOUTH
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37240-7804
Practice Address - Country:US
Practice Address - Phone:615-343-2638
Practice Address - Fax:615-343-3029
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN305133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered