Provider Demographics
NPI:1376793448
Name:MCCOY, KALYN C (MPH,RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:KALYN
Middle Name:C
Last Name:MCCOY
Suffix:
Gender:F
Credentials:MPH,RDN, LDN
Other - Prefix:MRS
Other - First Name:KALYN
Other - Middle Name:M
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH, RDN, LDN
Mailing Address - Street 1:5046 SANTANA ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2895
Mailing Address - Country:US
Mailing Address - Phone:601-320-0590
Mailing Address - Fax:
Practice Address - Street 1:221 STEWARTS FERRY PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-3325
Practice Address - Country:US
Practice Address - Phone:615-902-7524
Practice Address - Fax:615-902-7520
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003287133V00000X
TN2642133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty