Provider Demographics
NPI:1417027947
Name:GATZOW, LINDSEY MAE (RD LD)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:MAE
Last Name:GATZOW
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 1:162 APPLEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-4600
Mailing Address - Country:US
Mailing Address - Phone:256-457-1347
Mailing Address - Fax:
Practice Address - Street 1:162 APPLEBERRY LN
Practice Address - Street 2:
Practice Address - City:HARVEST
Practice Address - State:AL
Practice Address - Zip Code:35749-4600
Practice Address - Country:US
Practice Address - Phone:256-457-1347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1317133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal