Provider Demographics
NPI:1457489957
Name:HUMPHREY, WENDY DARLENE (MS, RD)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:DARLENE
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2837 CANDLEWICKE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-9291
Mailing Address - Country:US
Mailing Address - Phone:615-302-3169
Mailing Address - Fax:
Practice Address - Street 1:100 BLYTHEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4828
Practice Address - Country:US
Practice Address - Phone:931-388-5757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered