Provider Demographics
NPI:1225795883
Name:LOKKEN, ALLIE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:ALLIE
Middle Name:
Last Name:LOKKEN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-8112
Mailing Address - Country:US
Mailing Address - Phone:901-326-7833
Mailing Address - Fax:
Practice Address - Street 1:2119 WOODBINE AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-8112
Practice Address - Country:US
Practice Address - Phone:901-326-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3818133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered