Provider Demographics
NPI:1144593153
Name:HOLMES, CINDY R (RD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:R
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 1:422 CATAWBA LN
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-4913
Mailing Address - Country:US
Mailing Address - Phone:423-384-3827
Mailing Address - Fax:
Practice Address - Street 1:422 CATAWBA LN
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-4913
Practice Address - Country:US
Practice Address - Phone:423-384-3827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered