Provider Demographics
NPI:1548387830
Name:NATARAJAN, GEETHA (RD LDN)
Entity Type:Individual
Prefix:
First Name:GEETHA
Middle Name:
Last Name:NATARAJAN
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2149 WILLIAMSBURG CIR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-3401
Mailing Address - Country:US
Mailing Address - Phone:931-432-6647
Mailing Address - Fax:
Practice Address - Street 1:200 W 10TH ST
Practice Address - Street 2:DEPARTMENT OF HEALTH
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-6077
Practice Address - Country:US
Practice Address - Phone:931-528-7531
Practice Address - Fax:931-520-0413
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000000412133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered