Provider Demographics
NPI:1144766445
Name:SELLS, ALISON (MS, RD, CSO)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:
Last Name:SELLS
Suffix:
Gender:F
Credentials:MS, RD, CSO
Other - Prefix:MS
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:PULLIAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 MARIAN DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-3705
Mailing Address - Country:US
Mailing Address - Phone:502-599-9531
Mailing Address - Fax:
Practice Address - Street 1:301 MARIAN DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3705
Practice Address - Country:US
Practice Address - Phone:502-599-9531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY122201133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered