Provider Demographics
NPI:1467856096
Name:LAYNE-DAVIDSON, ALYSON (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:LAYNE-DAVIDSON
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 1:2471 THORNBERRY CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2433 REGENCY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3043
Practice Address - Country:US
Practice Address - Phone:859-899-5260
Practice Address - Fax:859-899-5235
Is Sole Proprietor?:No
Enumeration Date:2014-10-10
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY122579133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered