Provider Demographics
NPI:1376711432
Name:RAILTON, NATASHA ELIZABETH (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:ELIZABETH
Last Name:RAILTON
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HIGHLANDER POINT DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9465
Mailing Address - Country:US
Mailing Address - Phone:812-542-4921
Mailing Address - Fax:812-949-5966
Practice Address - Street 1:2019 STATE STREET
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4921
Practice Address - Country:US
Practice Address - Phone:812-949-5591
Practice Address - Fax:812-949-5791
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2048133V00000X
IN37002611A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered