Provider Demographics
NPI:1467165936
Name:SMYERS, JOANNA RUTH GUEST (MS, RD, LD)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:RUTH GUEST
Last Name:SMYERS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 CEDAR PINES DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6241
Mailing Address - Country:US
Mailing Address - Phone:864-729-3003
Mailing Address - Fax:
Practice Address - Street 1:135 COMMONWEALTH DR STE 210
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4850
Practice Address - Country:US
Practice Address - Phone:864-675-4818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLRD.1691133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered