Provider Demographics
NPI:1477186591
Name:MADDUX, EMILY SMITH (MS-MPH, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SMITH
Last Name:MADDUX
Suffix:
Gender:F
Credentials:MS-MPH, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7811 SCRAPESHIN TRL
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4292
Mailing Address - Country:US
Mailing Address - Phone:423-667-4312
Mailing Address - Fax:
Practice Address - Street 1:7811 SCRAPESHIN TRL
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4292
Practice Address - Country:US
Practice Address - Phone:423-667-4312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1936133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered