Provider Demographics
NPI:1346722519
Name:MASON, JULIE (RD/LDN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:RD/LDN
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:HOLLIDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD/LDN
Mailing Address - Street 1:8222 FRONTIER LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7318
Mailing Address - Country:US
Mailing Address - Phone:615-310-3278
Mailing Address - Fax:
Practice Address - Street 1:2424 21ST AVE S STE 201
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-5315
Practice Address - Country:US
Practice Address - Phone:615-861-9146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000001808133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered