Provider Demographics
NPI:1417538562
Name:FINCHUM, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:FINCHUM
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:LOZANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:150 E SWAN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37033-1446
Mailing Address - Country:US
Mailing Address - Phone:931-729-3091
Mailing Address - Fax:931-729-0809
Practice Address - Street 1:135 E SWAN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37033-1417
Practice Address - Country:US
Practice Address - Phone:931-729-6776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2976133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered