Provider Demographics
NPI:1477793818
Name:CHADWELL, ERIN (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CHADWELL
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 1:276 WOODLEE LN
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:KY
Mailing Address - Zip Code:40734-6536
Mailing Address - Country:US
Mailing Address - Phone:606-524-5334
Mailing Address - Fax:
Practice Address - Street 1:276 WOODLEE LN
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:KY
Practice Address - Zip Code:40734-6536
Practice Address - Country:US
Practice Address - Phone:606-524-5334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2257133V00000X
TN1940133V00000X
SC719133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered