Provider Demographics
NPI:1427947399
Name:ANTHONY, ASHLYN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 PARC MONCEAU DR W
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-1059
Mailing Address - Country:US
Mailing Address - Phone:662-523-0001
Mailing Address - Fax:
Practice Address - Street 1:2080 PARC MONCEAU DR W
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-1059
Practice Address - Country:US
Practice Address - Phone:662-523-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD-2705133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered