Provider Demographics
NPI:1114626413
Name:FAYIK, MONICA (RD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:FAYIK
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 1:3021 BRANTLEY DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1358
Mailing Address - Country:US
Mailing Address - Phone:615-967-6859
Mailing Address - Fax:
Practice Address - Street 1:3021 BRANTLEY DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-1358
Practice Address - Country:US
Practice Address - Phone:615-967-6859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered