Provider Demographics
NPI:1164470142
Name:HATCHER, CYNTHIA ZIMMERMAN (RD ,LDN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ZIMMERMAN
Last Name:HATCHER
Suffix:
Gender:F
Credentials:RD ,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 OWL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:TN
Mailing Address - Zip Code:37306-2611
Mailing Address - Country:US
Mailing Address - Phone:931-308-5719
Mailing Address - Fax:
Practice Address - Street 1:3317 OWL HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:TN
Practice Address - Zip Code:37306-2611
Practice Address - Country:US
Practice Address - Phone:931-308-5719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000000264133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3241765Medicare ID - Type UnspecifiedPERFORMING PROVIDER NUMBE