Provider Demographics
NPI:1174277024
Name:HULL, GRAYSON LEIGH (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:GRAYSON
Middle Name:LEIGH
Last Name:HULL
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CAUREL LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5266
Mailing Address - Country:US
Mailing Address - Phone:901-870-0516
Mailing Address - Fax:
Practice Address - Street 1:131 FRENCH LANDING DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1501
Practice Address - Country:US
Practice Address - Phone:615-925-3894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1995133NN1002X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education